National Provider Identifier [NPI]: |
1609061191 |
Last Name Of The Provider |
SHUM |
First Name Of The Provider |
LEO |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
M.D |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
959 E WALNUT ST |
Street Address 2 Of The Provider |
SUITE 120 |
City Of The Provider |
PASADENA |
Zip Code Of The Provider |
911061451 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
13 |
Number Of Services |
1133 |
Number Of Medicare Beneficiaries |
264 |
Total Submitted Charge Amount |
381620 |
Total Medicare Allowed Amount |
209288.68 |
Total Medicare Payment Amount |
163831.74 |
Total Medicare Standardized Payment Amount |
153979.84 |
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 |
13 |
Number Of Medical Services |
1133 |
Number Of Medicare Beneficiaries With Medical Services |
264 |
Total Medical Submitted Charge Amount |
381620 |
Total Medical Medicare Allowed Amount |
209288.68 |
Total Medical Medicare Payment Amount |
163831.74 |
Total Medical Medicare Standardized Payment Amount |
153979.84 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
34 |
Number Of Beneficiaries Age 65 to 74 |
67 |
Number Of Beneficiaries Age 75 to 84 |
99 |
Number Of Beneficiaries Age Greater 84 |
64 |
Number Of Female Beneficiaries |
140 |
Number Of Male Beneficiaries |
124 |
Number Of Non Hispanic White Beneficiaries |
136 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
55 |
Number Of Hispanic Beneficiaries |
58 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
111 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
153 |
Percent Of With Atrial Fibrillation |
34 |
Percent Of With Alzheimers Disease or Dementia |
39 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
69 |
Percent Of With Chronic Kidney Disease |
74 |
Percent Of With Chronic Obstructive Pulmonary Disease |
52 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
64 |
Percent Of With Hyperlipidemia |
70 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
70 |
Percent Of With Osteoporosis |
18 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
54 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
27 |
Average HCC Risk Score Of Beneficiaries |
3.3756 |