National Provider Identifier [NPI]: |
1083627798 |
Last Name Of The Provider |
LEONG |
First Name Of The Provider |
JASMINE |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1280 CORONA POINTE CT STE 118 |
Street Address 2 Of The Provider |
|
City Of The Provider |
CORONA |
Zip Code Of The Provider |
928791770 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
36 |
Number Of Services |
643 |
Number Of Medicare Beneficiaries |
129 |
Total Submitted Charge Amount |
69764 |
Total Medicare Allowed Amount |
56006.84 |
Total Medicare Payment Amount |
39002.73 |
Total Medicare Standardized Payment Amount |
38040.72 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
44 |
Number Of Medicare Beneficiaries With Drug Services |
37 |
Total Drug Submitted ChargeAmount |
2195 |
Total Drug Medicare AllowedAmount |
1597.79 |
Total Drug Medicare PaymentAmount |
1561.61 |
Total Drug Medicare Standardized Payment Amount |
1561.61 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
30 |
Number Of Medical Services |
599 |
Number Of Medicare Beneficiaries With Medical Services |
129 |
Total Medical Submitted Charge Amount |
67569 |
Total Medical Medicare Allowed Amount |
54409.05 |
Total Medical Medicare Payment Amount |
37441.12 |
Total Medical Medicare Standardized Payment Amount |
36479.11 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
30 |
Number Of Beneficiaries Age 65 to 74 |
49 |
Number Of Beneficiaries Age 75 to 84 |
30 |
Number Of Beneficiaries Age Greater 84 |
20 |
Number Of Female Beneficiaries |
93 |
Number Of Male Beneficiaries |
36 |
Number Of Non Hispanic White Beneficiaries |
77 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
33 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
82 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
47 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
27 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
66 |
Percent Of With Ischemic Heart Disease |
19 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
23 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.2165 |