National Provider Identifier [NPI]: |
1770548596 |
Last Name Of The Provider |
VU |
First Name Of The Provider |
KHAI |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
11190 WARNER AVE. |
Street Address 2 Of The Provider |
SUITE 411 |
City Of The Provider |
FOUNTAIN VALLEY |
Zip Code Of The Provider |
927084019 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Hematology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
79 |
Number Of Services |
72082 |
Number Of Medicare Beneficiaries |
358 |
Total Submitted Charge Amount |
2279154 |
Total Medicare Allowed Amount |
1205284.94 |
Total Medicare Payment Amount |
928279.1 |
Total Medicare Standardized Payment Amount |
886110.55 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
43 |
Number Of Drug Services |
60563 |
Number Of Medicare Beneficiaries With Drug Services |
144 |
Total Drug Submitted ChargeAmount |
1685444 |
Total Drug Medicare AllowedAmount |
785328.74 |
Total Drug Medicare PaymentAmount |
614187.18 |
Total Drug Medicare Standardized Payment Amount |
614187.18 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
36 |
Number Of Medical Services |
11519 |
Number Of Medicare Beneficiaries With Medical Services |
358 |
Total Medical Submitted Charge Amount |
593710 |
Total Medical Medicare Allowed Amount |
419956.2 |
Total Medical Medicare Payment Amount |
314091.92 |
Total Medical Medicare Standardized Payment Amount |
271923.37 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
17 |
Number Of Beneficiaries Age 65 to 74 |
141 |
Number Of Beneficiaries Age 75 to 84 |
135 |
Number Of Beneficiaries Age Greater 84 |
65 |
Number Of Female Beneficiaries |
189 |
Number Of Male Beneficiaries |
169 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
345 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
26 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
332 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
21 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
38 |
Percent Of With Heart Failure |
23 |
Percent Of With Chronic Kidney Disease |
47 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
9 |
Percent Of With Diabetes |
55 |
Percent Of With Hyperlipidemia |
70 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
51 |
Percent Of With Osteoporosis |
22 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
2.2253 |