National Provider Identifier [NPI]: |
1831192640 |
Last Name Of The Provider |
CHAE |
First Name Of The Provider |
WON |
Middle Initial Of The Provider |
B |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
29829 TELEGRAPH RD |
Street Address 2 Of The Provider |
STE L103 |
City Of The Provider |
SOUTHFIELD |
Zip Code Of The Provider |
480341376 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
182 |
Number Of Services |
29161 |
Number Of Medicare Beneficiaries |
3742 |
Total Submitted Charge Amount |
1961244.05 |
Total Medicare Allowed Amount |
945389.29 |
Total Medicare Payment Amount |
746891.05 |
Total Medicare Standardized Payment Amount |
747934.7 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
19882 |
Number Of Medicare Beneficiaries With Drug Services |
208 |
Total Drug Submitted ChargeAmount |
21461.48 |
Total Drug Medicare AllowedAmount |
3973.52 |
Total Drug Medicare PaymentAmount |
3115.19 |
Total Drug Medicare Standardized Payment Amount |
3115.19 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
178 |
Number Of Medical Services |
9279 |
Number Of Medicare Beneficiaries With Medical Services |
3742 |
Total Medical Submitted Charge Amount |
1939782.57 |
Total Medical Medicare Allowed Amount |
941415.77 |
Total Medical Medicare Payment Amount |
743775.86 |
Total Medical Medicare Standardized Payment Amount |
744819.51 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
708 |
Number Of Beneficiaries Age 65 to 74 |
1560 |
Number Of Beneficiaries Age 75 to 84 |
974 |
Number Of Beneficiaries Age Greater 84 |
500 |
Number Of Female Beneficiaries |
2574 |
Number Of Male Beneficiaries |
1168 |
Number Of Non Hispanic White Beneficiaries |
2465 |
Number Of Black or African American Beneficiaries |
1137 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
43 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
58 |
Number Of Beneficiaries With Medicare Only Entitlement |
2843 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
899 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
28 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
53 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
54 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.3492 |