National Provider Identifier [NPI]: |
1992720163 |
Last Name Of The Provider |
SUN |
First Name Of The Provider |
JEAN |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
PT |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
23456 HAWTHORNE BLVD. |
Street Address 2 Of The Provider |
SUITE 300B |
City Of The Provider |
TORRANCE |
Zip Code Of The Provider |
905054716 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physical Therapist |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
9 |
Number Of Services |
2178 |
Number Of Medicare Beneficiaries |
133 |
Total Submitted Charge Amount |
122230 |
Total Medicare Allowed Amount |
75973.53 |
Total Medicare Payment Amount |
58745.58 |
Total Medicare Standardized Payment Amount |
23108.13 |
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 |
9 |
Number Of Medical Services |
2178 |
Number Of Medicare Beneficiaries With Medical Services |
133 |
Total Medical Submitted Charge Amount |
122230 |
Total Medical Medicare Allowed Amount |
75973.53 |
Total Medical Medicare Payment Amount |
58745.58 |
Total Medical Medicare Standardized Payment Amount |
23108.13 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
14 |
Number Of Beneficiaries Age 65 to 74 |
69 |
Number Of Beneficiaries Age 75 to 84 |
37 |
Number Of Beneficiaries Age Greater 84 |
13 |
Number Of Female Beneficiaries |
99 |
Number Of Male Beneficiaries |
34 |
Number Of Non Hispanic White Beneficiaries |
108 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
11 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
14 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
24 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
67 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
18 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
0 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0151 |