National Provider Identifier [NPI]: |
1841497765 |
Last Name Of The Provider |
WANG |
First Name Of The Provider |
MINGWU |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD, PHD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1200 N STATE ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
LOS ANGELES |
Zip Code Of The Provider |
900331029 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Ophthalmology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
49 |
Number Of Services |
938 |
Number Of Medicare Beneficiaries |
444 |
Total Submitted Charge Amount |
501035 |
Total Medicare Allowed Amount |
138050.58 |
Total Medicare Payment Amount |
101632.53 |
Total Medicare Standardized Payment Amount |
100380.48 |
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 |
49 |
Number Of Medical Services |
938 |
Number Of Medicare Beneficiaries With Medical Services |
444 |
Total Medical Submitted Charge Amount |
501035 |
Total Medical Medicare Allowed Amount |
138050.58 |
Total Medical Medicare Payment Amount |
101632.53 |
Total Medical Medicare Standardized Payment Amount |
100380.48 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
40 |
Number Of Beneficiaries Age 65 to 74 |
201 |
Number Of Beneficiaries Age 75 to 84 |
164 |
Number Of Beneficiaries Age Greater 84 |
39 |
Number Of Female Beneficiaries |
256 |
Number Of Male Beneficiaries |
188 |
Number Of Non Hispanic White Beneficiaries |
340 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
13 |
Number Of Hispanic Beneficiaries |
71 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
352 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
92 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
4 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
24 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
64 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.162 |