National Provider Identifier [NPI]: |
1811172992 |
Last Name Of The Provider |
LIU |
First Name Of The Provider |
JING |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
|
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6500 W NEWBERRY RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
GAINESVILLE |
Zip Code Of The Provider |
326054309 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Psychiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
8 |
Number Of Services |
225 |
Number Of Medicare Beneficiaries |
151 |
Total Submitted Charge Amount |
16786.84 |
Total Medicare Allowed Amount |
14524.22 |
Total Medicare Payment Amount |
7830.98 |
Total Medicare Standardized Payment Amount |
10839.24 |
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 |
8 |
Number Of Medical Services |
225 |
Number Of Medicare Beneficiaries With Medical Services |
151 |
Total Medical Submitted Charge Amount |
16786.84 |
Total Medical Medicare Allowed Amount |
14524.22 |
Total Medical Medicare Payment Amount |
7830.98 |
Total Medical Medicare Standardized Payment Amount |
10839.24 |
Average Age Of Beneficiaries |
53 |
Number Of Beneficiaries Age Less65 |
123 |
Number Of Beneficiaries Age 65 to 74 |
|
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
80 |
Number Of Male Beneficiaries |
71 |
Number Of Non Hispanic White Beneficiaries |
92 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
21 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
130 |
Percent Of With Atrial Fibrillation |
0 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
7 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
46 |
Percent Of With Diabetes |
24 |
Percent Of With Hyperlipidemia |
32 |
Percent Of With Hypertension |
48 |
Percent Of With Ischemic Heart Disease |
19 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
28 |
Percent Of With Schizophrenia Other PsychoticDisorders |
52 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1336 |