National Provider Identifier [NPI]: |
1619941721 |
Last Name Of The Provider |
CHEN |
First Name Of The Provider |
ASHLEY |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2101 ALEXIAN DR |
Street Address 2 Of The Provider |
SUITE C |
City Of The Provider |
SAN JOSE |
Zip Code Of The Provider |
951161901 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Psychiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
4 |
Number Of Services |
171 |
Number Of Medicare Beneficiaries |
119 |
Total Submitted Charge Amount |
35233 |
Total Medicare Allowed Amount |
13754.94 |
Total Medicare Payment Amount |
5518.24 |
Total Medicare Standardized Payment Amount |
4540.36 |
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 |
4 |
Number Of Medical Services |
171 |
Number Of Medicare Beneficiaries With Medical Services |
119 |
Total Medical Submitted Charge Amount |
35233 |
Total Medical Medicare Allowed Amount |
13754.94 |
Total Medical Medicare Payment Amount |
5518.24 |
Total Medical Medicare Standardized Payment Amount |
4540.36 |
Average Age Of Beneficiaries |
56 |
Number Of Beneficiaries Age Less65 |
92 |
Number Of Beneficiaries Age 65 to 74 |
|
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
45 |
Number Of Male Beneficiaries |
74 |
Number Of Non Hispanic White Beneficiaries |
77 |
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 |
24 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
95 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
12 |
Percent Of With Cancer |
0 |
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
10 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
24 |
Percent Of With Hyperlipidemia |
35 |
Percent Of With Hypertension |
38 |
Percent Of With Ischemic Heart Disease |
9 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
10 |
Percent Of With Schizophrenia Other PsychoticDisorders |
71 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9244 |