National Provider Identifier [NPI]: |
1093873119 |
Last Name Of The Provider |
YANG |
First Name Of The Provider |
SHU |
Middle Initial Of The Provider |
Q |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
122 CALISTOGA ROAD #396 |
Street Address 2 Of The Provider |
|
City Of The Provider |
SANTA ROSA |
Zip Code Of The Provider |
954093702 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Infectious Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
9 |
Number Of Services |
984 |
Number Of Medicare Beneficiaries |
288 |
Total Submitted Charge Amount |
237889 |
Total Medicare Allowed Amount |
106382.61 |
Total Medicare Payment Amount |
82285.22 |
Total Medicare Standardized Payment Amount |
80366.65 |
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 |
984 |
Number Of Medicare Beneficiaries With Medical Services |
288 |
Total Medical Submitted Charge Amount |
237889 |
Total Medical Medicare Allowed Amount |
106382.61 |
Total Medical Medicare Payment Amount |
82285.22 |
Total Medical Medicare Standardized Payment Amount |
80366.65 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
66 |
Number Of Beneficiaries Age 65 to 74 |
105 |
Number Of Beneficiaries Age 75 to 84 |
75 |
Number Of Beneficiaries Age Greater 84 |
42 |
Number Of Female Beneficiaries |
113 |
Number Of Male Beneficiaries |
175 |
Number Of Non Hispanic White Beneficiaries |
247 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
21 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
194 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
94 |
Percent Of With Atrial Fibrillation |
27 |
Percent Of With Alzheimers Disease or Dementia |
18 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
48 |
Percent Of With Chronic Kidney Disease |
60 |
Percent Of With Chronic Obstructive Pulmonary Disease |
33 |
Percent Of With Depression |
40 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
55 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
2.6582 |