| National Provider Identifier [NPI]: | 1154401354 |
| Last Name Of The Provider | OH |
| First Name Of The Provider | ANTHONY |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4950 SAN BERNARDINO ST |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | MONTCLAIR |
| Zip Code Of The Provider | 917632328 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | General Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 96 |
| Number Of Services | 1392 |
| Number Of Medicare Beneficiaries | 300 |
| Total Submitted Charge Amount | 326150 |
| Total Medicare Allowed Amount | 188423.52 |
| Total Medicare Payment Amount | 145975.54 |
| Total Medicare Standardized Payment Amount | 133264.18 |
| 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 | 96 |
| Number Of Medical Services | 1392 |
| Number Of Medicare Beneficiaries With Medical Services | 300 |
| Total Medical Submitted Charge Amount | 326150 |
| Total Medical Medicare Allowed Amount | 188423.52 |
| Total Medical Medicare Payment Amount | 145975.54 |
| Total Medical Medicare Standardized Payment Amount | 133264.18 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 79 |
| Number Of Beneficiaries Age 65 to 74 | 92 |
| Number Of Beneficiaries Age 75 to 84 | 86 |
| Number Of Beneficiaries Age Greater 84 | 43 |
| Number Of Female Beneficiaries | 155 |
| Number Of Male Beneficiaries | 145 |
| Number Of Non Hispanic White Beneficiaries | 117 |
| Number Of Black or African American Beneficiaries | 40 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 114 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 83 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 217 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 41 |
| Percent Of With Asthma | 18 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 58 |
| Percent Of With Chronic Kidney Disease | 62 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 48 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 60 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 62 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 15 |
| Percent Of With Stroke | 22 |
| Average HCC Risk Score Of Beneficiaries | 3.862 |