National Provider Identifier [NPI]: |
1811987126 |
Last Name Of The Provider |
UJJIN |
First Name Of The Provider |
ROAJ |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
700 CHURCH ST NE |
Street Address 2 Of The Provider |
|
City Of The Provider |
MARIETTA |
Zip Code Of The Provider |
300607220 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
44 |
Number Of Services |
2048 |
Number Of Medicare Beneficiaries |
420 |
Total Submitted Charge Amount |
191732 |
Total Medicare Allowed Amount |
94818.59 |
Total Medicare Payment Amount |
66680.55 |
Total Medicare Standardized Payment Amount |
67341.91 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
11 |
Number Of Drug Services |
179 |
Number Of Medicare Beneficiaries With Drug Services |
113 |
Total Drug Submitted ChargeAmount |
9017 |
Total Drug Medicare AllowedAmount |
4529.23 |
Total Drug Medicare PaymentAmount |
4398.23 |
Total Drug Medicare Standardized Payment Amount |
4398.23 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
33 |
Number Of Medical Services |
1869 |
Number Of Medicare Beneficiaries With Medical Services |
420 |
Total Medical Submitted Charge Amount |
182715 |
Total Medical Medicare Allowed Amount |
90289.36 |
Total Medical Medicare Payment Amount |
62282.32 |
Total Medical Medicare Standardized Payment Amount |
62943.68 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
29 |
Number Of Beneficiaries Age 65 to 74 |
182 |
Number Of Beneficiaries Age 75 to 84 |
149 |
Number Of Beneficiaries Age Greater 84 |
60 |
Number Of Female Beneficiaries |
210 |
Number Of Male Beneficiaries |
210 |
Number Of Non Hispanic White Beneficiaries |
361 |
Number Of Black or African American Beneficiaries |
44 |
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 |
401 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
19 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
4 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
14 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
36 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.1878 |