National Provider Identifier [NPI]: |
1174647077 |
Last Name Of The Provider |
TANAKA |
First Name Of The Provider |
LINDA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.A. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
933 S SUNSET AVE |
Street Address 2 Of The Provider |
302 |
City Of The Provider |
WEST COVINA |
Zip Code Of The Provider |
917903410 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Audiologist (billing independently) |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
4 |
Number Of Services |
878 |
Number Of Medicare Beneficiaries |
384 |
Total Submitted Charge Amount |
63260 |
Total Medicare Allowed Amount |
33403.17 |
Total Medicare Payment Amount |
25695.3 |
Total Medicare Standardized Payment Amount |
22892.54 |
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 |
4 |
Number Of Medical Services |
878 |
Number Of Medicare Beneficiaries With Medical Services |
384 |
Total Medical Submitted Charge Amount |
63260 |
Total Medical Medicare Allowed Amount |
33403.17 |
Total Medical Medicare Payment Amount |
25695.3 |
Total Medical Medicare Standardized Payment Amount |
22892.54 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
44 |
Number Of Beneficiaries Age 65 to 74 |
102 |
Number Of Beneficiaries Age 75 to 84 |
131 |
Number Of Beneficiaries Age Greater 84 |
107 |
Number Of Female Beneficiaries |
226 |
Number Of Male Beneficiaries |
158 |
Number Of Non Hispanic White Beneficiaries |
118 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
48 |
Number Of Hispanic Beneficiaries |
201 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
106 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
278 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
16 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
23 |
Percent Of With Chronic Kidney Disease |
33 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
46 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
41 |
Percent Of With Osteoporosis |
16 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.6818 |