National Provider Identifier [NPI]: |
1174581508 |
Last Name Of The Provider |
CHONG |
First Name Of The Provider |
LAURA |
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 |
750 NE 13TH ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
OKLAHOMA CITY |
Zip Code Of The Provider |
731045010 |
State Code Of The Provider |
OK |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Allergy/Immunology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
27 |
Number Of Services |
9117 |
Number Of Medicare Beneficiaries |
265 |
Total Submitted Charge Amount |
157876 |
Total Medicare Allowed Amount |
106574.03 |
Total Medicare Payment Amount |
78811.38 |
Total Medicare Standardized Payment Amount |
82618.22 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
11 |
Number Of Medicare Beneficiaries With Drug Services |
11 |
Total Drug Submitted ChargeAmount |
265 |
Total Drug Medicare AllowedAmount |
238.36 |
Total Drug Medicare PaymentAmount |
233.6 |
Total Drug Medicare Standardized Payment Amount |
233.6 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
25 |
Number Of Medical Services |
9106 |
Number Of Medicare Beneficiaries With Medical Services |
265 |
Total Medical Submitted Charge Amount |
157611 |
Total Medical Medicare Allowed Amount |
106335.67 |
Total Medical Medicare Payment Amount |
78577.78 |
Total Medical Medicare Standardized Payment Amount |
82384.62 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
32 |
Number Of Beneficiaries Age 65 to 74 |
156 |
Number Of Beneficiaries Age 75 to 84 |
62 |
Number Of Beneficiaries Age Greater 84 |
15 |
Number Of Female Beneficiaries |
185 |
Number Of Male Beneficiaries |
80 |
Number Of Non Hispanic White Beneficiaries |
239 |
Number Of Black or African American Beneficiaries |
15 |
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 |
242 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
23 |
Percent Of With Atrial Fibrillation |
5 |
Percent Of With Alzheimers Disease or Dementia |
4 |
Percent Of With Asthma |
34 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
8 |
Percent Of With Chronic Kidney Disease |
11 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
20 |
Percent Of With Hyperlipidemia |
46 |
Percent Of With Hypertension |
59 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.826 |