National Provider Identifier [NPI]: |
1033112818 |
Last Name Of The Provider |
LEE |
First Name Of The Provider |
SUNGCHUN |
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 |
15255 N 40TH ST |
Street Address 2 Of The Provider |
BLDG 5, STE 135 |
City Of The Provider |
PHOENIX |
Zip Code Of The Provider |
850320000 |
State Code Of The Provider |
AZ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nephrology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
28 |
Number Of Services |
17512 |
Number Of Medicare Beneficiaries |
579 |
Total Submitted Charge Amount |
635242 |
Total Medicare Allowed Amount |
315883.13 |
Total Medicare Payment Amount |
236914.36 |
Total Medicare Standardized Payment Amount |
241431.91 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
15142 |
Number Of Medicare Beneficiaries With Drug Services |
19 |
Total Drug Submitted ChargeAmount |
39342 |
Total Drug Medicare AllowedAmount |
17716.24 |
Total Drug Medicare PaymentAmount |
13709.78 |
Total Drug Medicare Standardized Payment Amount |
13709.78 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
25 |
Number Of Medical Services |
2370 |
Number Of Medicare Beneficiaries With Medical Services |
579 |
Total Medical Submitted Charge Amount |
595900 |
Total Medical Medicare Allowed Amount |
298166.89 |
Total Medical Medicare Payment Amount |
223204.58 |
Total Medical Medicare Standardized Payment Amount |
227722.13 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
101 |
Number Of Beneficiaries Age 65 to 74 |
245 |
Number Of Beneficiaries Age 75 to 84 |
154 |
Number Of Beneficiaries Age Greater 84 |
79 |
Number Of Female Beneficiaries |
259 |
Number Of Male Beneficiaries |
320 |
Number Of Non Hispanic White Beneficiaries |
471 |
Number Of Black or African American Beneficiaries |
37 |
Number Of AsianPacific Islander Beneficiaries |
13 |
Number Of Hispanic Beneficiaries |
45 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
459 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
120 |
Percent Of With Atrial Fibrillation |
22 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
39 |
Percent Of With Chronic Kidney Disease |
75 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
52 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
53 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
3.0038 |