National Provider Identifier [NPI]: |
1942356365 |
Last Name Of The Provider |
LIU |
First Name Of The Provider |
ZHAO |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D., PHD. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1739 E BEVERLY AVE STE 216 |
Street Address 2 Of The Provider |
|
City Of The Provider |
KINGMAN |
Zip Code Of The Provider |
864093593 |
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 |
27 |
Number Of Services |
6513 |
Number Of Medicare Beneficiaries |
776 |
Total Submitted Charge Amount |
893557 |
Total Medicare Allowed Amount |
447247.02 |
Total Medicare Payment Amount |
337236.06 |
Total Medicare Standardized Payment Amount |
344562.24 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
99 |
Number Of Beneficiaries Age 65 to 74 |
301 |
Number Of Beneficiaries Age 75 to 84 |
278 |
Number Of Beneficiaries Age Greater 84 |
98 |
Number Of Female Beneficiaries |
352 |
Number Of Male Beneficiaries |
424 |
Number Of Non Hispanic White Beneficiaries |
699 |
Number Of Black or African American Beneficiaries |
12 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
30 |
Number Of American Indian Alaska Native Beneficiaries |
19 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
630 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
146 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
46 |
Percent Of With Chronic Kidney Disease |
75 |
Percent Of With Chronic Obstructive Pulmonary Disease |
38 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
55 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
57 |
Percent Of With Osteoporosis |
4 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
35 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
2.6517 |