National Provider Identifier [NPI]: |
1497712715 |
Last Name Of The Provider |
SUN |
First Name Of The Provider |
ADAM |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
455 N GARFIELD AVE |
Street Address 2 Of The Provider |
2ND FL |
City Of The Provider |
MONTEREY PARK |
Zip Code Of The Provider |
91754 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nephrology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
16 |
Number Of Services |
2699 |
Number Of Medicare Beneficiaries |
422 |
Total Submitted Charge Amount |
983120 |
Total Medicare Allowed Amount |
441858.6 |
Total Medicare Payment Amount |
346048.36 |
Total Medicare Standardized Payment Amount |
323736.85 |
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 |
16 |
Number Of Medical Services |
2699 |
Number Of Medicare Beneficiaries With Medical Services |
422 |
Total Medical Submitted Charge Amount |
983120 |
Total Medical Medicare Allowed Amount |
441858.6 |
Total Medical Medicare Payment Amount |
346048.36 |
Total Medical Medicare Standardized Payment Amount |
323736.85 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
54 |
Number Of Beneficiaries Age 65 to 74 |
87 |
Number Of Beneficiaries Age 75 to 84 |
153 |
Number Of Beneficiaries Age Greater 84 |
128 |
Number Of Female Beneficiaries |
207 |
Number Of Male Beneficiaries |
215 |
Number Of Non Hispanic White Beneficiaries |
22 |
Number Of Black or African American Beneficiaries |
18 |
Number Of AsianPacific Islander Beneficiaries |
319 |
Number Of Hispanic Beneficiaries |
49 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
14 |
Number Of Beneficiaries With Medicare Only Entitlement |
53 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
369 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
39 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
50 |
Percent Of With Chronic Kidney Disease |
75 |
Percent Of With Chronic Obstructive Pulmonary Disease |
38 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
74 |
Percent Of With Hyperlipidemia |
70 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
24 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
3.9323 |