National Provider Identifier [NPI]: |
1457594772 |
Last Name Of The Provider |
ING |
First Name Of The Provider |
JAKUN |
Middle Initial Of The Provider |
W |
Credentials Of The Provider |
M.D., M.P.H. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
757 WESTWOOD PLZ |
Street Address 2 Of The Provider |
SUITE 3325 |
City Of The Provider |
LOS ANGELES |
Zip Code Of The Provider |
900957403 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
33 |
Number Of Services |
487 |
Number Of Medicare Beneficiaries |
147 |
Total Submitted Charge Amount |
227525.5 |
Total Medicare Allowed Amount |
45041.33 |
Total Medicare Payment Amount |
35313.44 |
Total Medicare Standardized Payment Amount |
32801.51 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
33 |
Number Of Medical Services |
487 |
Number Of Medicare Beneficiaries With Medical Services |
147 |
Total Medical Submitted Charge Amount |
227525.5 |
Total Medical Medicare Allowed Amount |
45041.33 |
Total Medical Medicare Payment Amount |
35313.44 |
Total Medical Medicare Standardized Payment Amount |
32801.51 |
Average Age Of Beneficiaries |
62 |
Number Of Beneficiaries Age Less65 |
63 |
Number Of Beneficiaries Age 65 to 74 |
52 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
95 |
Number Of Male Beneficiaries |
52 |
Number Of Non Hispanic White Beneficiaries |
94 |
Number Of Black or African American Beneficiaries |
19 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
20 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
76 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
71 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
18 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
27 |
Percent Of With Chronic Kidney Disease |
38 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
52 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
47 |
Percent Of With Hypertension |
67 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
16 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
74 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
2.5996 |