National Provider Identifier [NPI]: |
1134291206 |
Last Name Of The Provider |
CHIN |
First Name Of The Provider |
JOHN |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
999 S FAIRMONT AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
LODI |
Zip Code Of The Provider |
952405100 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
52 |
Number Of Services |
2240 |
Number Of Medicare Beneficiaries |
561 |
Total Submitted Charge Amount |
927546 |
Total Medicare Allowed Amount |
273284.04 |
Total Medicare Payment Amount |
202034.88 |
Total Medicare Standardized Payment Amount |
199369.71 |
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 |
52 |
Number Of Medical Services |
2240 |
Number Of Medicare Beneficiaries With Medical Services |
561 |
Total Medical Submitted Charge Amount |
927546 |
Total Medical Medicare Allowed Amount |
273284.04 |
Total Medical Medicare Payment Amount |
202034.88 |
Total Medical Medicare Standardized Payment Amount |
199369.71 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
75 |
Number Of Beneficiaries Age 65 to 74 |
206 |
Number Of Beneficiaries Age 75 to 84 |
185 |
Number Of Beneficiaries Age Greater 84 |
95 |
Number Of Female Beneficiaries |
224 |
Number Of Male Beneficiaries |
337 |
Number Of Non Hispanic White Beneficiaries |
388 |
Number Of Black or African American Beneficiaries |
24 |
Number Of AsianPacific Islander Beneficiaries |
91 |
Number Of Hispanic Beneficiaries |
44 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
425 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
136 |
Percent Of With Atrial Fibrillation |
31 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
54 |
Percent Of With Chronic Kidney Disease |
45 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
16 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
70 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.9709 |