National Provider Identifier [NPI]: |
1912137662 |
Last Name Of The Provider |
CHUNGFAT |
First Name Of The Provider |
NEIL |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5151 BIOINFORMATICS BLDG |
Street Address 2 Of The Provider |
CB# 7040 |
City Of The Provider |
CHAPEL HILL |
Zip Code Of The Provider |
275990001 |
State Code Of The Provider |
NC |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Ophthalmology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
25 |
Number Of Services |
138 |
Number Of Medicare Beneficiaries |
96 |
Total Submitted Charge Amount |
56761 |
Total Medicare Allowed Amount |
15851.3 |
Total Medicare Payment Amount |
11876.79 |
Total Medicare Standardized Payment Amount |
11796.67 |
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 |
25 |
Number Of Medical Services |
138 |
Number Of Medicare Beneficiaries With Medical Services |
96 |
Total Medical Submitted Charge Amount |
56761 |
Total Medical Medicare Allowed Amount |
15851.3 |
Total Medical Medicare Payment Amount |
11876.79 |
Total Medical Medicare Standardized Payment Amount |
11796.67 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
21 |
Number Of Beneficiaries Age 65 to 74 |
42 |
Number Of Beneficiaries Age 75 to 84 |
22 |
Number Of Beneficiaries Age Greater 84 |
11 |
Number Of Female Beneficiaries |
60 |
Number Of Male Beneficiaries |
36 |
Number Of Non Hispanic White Beneficiaries |
64 |
Number Of Black or African American Beneficiaries |
16 |
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 |
64 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
32 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
26 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
25 |
Percent Of With Hyperlipidemia |
43 |
Percent Of With Hypertension |
60 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.3946 |