National Provider Identifier [NPI]: |
1952328585 |
Last Name Of The Provider |
LIN |
First Name Of The Provider |
JIMMY |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2411 FOREST AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
SAN JOSE |
Zip Code Of The Provider |
951281505 |
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 |
27 |
Number Of Services |
3550 |
Number Of Medicare Beneficiaries |
408 |
Total Submitted Charge Amount |
338325 |
Total Medicare Allowed Amount |
242123.8 |
Total Medicare Payment Amount |
163978.04 |
Total Medicare Standardized Payment Amount |
139711.33 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
958 |
Number Of Medicare Beneficiaries With Drug Services |
179 |
Total Drug Submitted ChargeAmount |
23300 |
Total Drug Medicare AllowedAmount |
16145.51 |
Total Drug Medicare PaymentAmount |
13531.51 |
Total Drug Medicare Standardized Payment Amount |
13531.51 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
23 |
Number Of Medical Services |
2592 |
Number Of Medicare Beneficiaries With Medical Services |
408 |
Total Medical Submitted Charge Amount |
315025 |
Total Medical Medicare Allowed Amount |
225978.29 |
Total Medical Medicare Payment Amount |
150446.53 |
Total Medical Medicare Standardized Payment Amount |
126179.82 |
Average Age Of Beneficiaries |
79 |
Number Of Beneficiaries Age Less65 |
13 |
Number Of Beneficiaries Age 65 to 74 |
135 |
Number Of Beneficiaries Age 75 to 84 |
129 |
Number Of Beneficiaries Age Greater 84 |
131 |
Number Of Female Beneficiaries |
243 |
Number Of Male Beneficiaries |
165 |
Number Of Non Hispanic White Beneficiaries |
77 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
303 |
Number Of Hispanic Beneficiaries |
14 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
209 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
199 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
|
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
27 |
Percent Of With Chronic Obstructive Pulmonary Disease |
3 |
Percent Of With Depression |
4 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
28 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
16 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.0075 |