National Provider Identifier [NPI]: |
1720003759 |
Last Name Of The Provider |
LIN |
First Name Of The Provider |
ANTHONY |
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 |
2425 SAMARITAN DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
SAN JOSE |
Zip Code Of The Provider |
951243908 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
57 |
Number Of Services |
226 |
Number Of Medicare Beneficiaries |
164 |
Total Submitted Charge Amount |
245289 |
Total Medicare Allowed Amount |
52373.1 |
Total Medicare Payment Amount |
41060.53 |
Total Medicare Standardized Payment Amount |
38311.38 |
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 |
57 |
Number Of Medical Services |
226 |
Number Of Medicare Beneficiaries With Medical Services |
164 |
Total Medical Submitted Charge Amount |
245289 |
Total Medical Medicare Allowed Amount |
52373.1 |
Total Medical Medicare Payment Amount |
41060.53 |
Total Medical Medicare Standardized Payment Amount |
38311.38 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
16 |
Number Of Beneficiaries Age 65 to 74 |
73 |
Number Of Beneficiaries Age 75 to 84 |
58 |
Number Of Beneficiaries Age Greater 84 |
17 |
Number Of Female Beneficiaries |
94 |
Number Of Male Beneficiaries |
70 |
Number Of Non Hispanic White Beneficiaries |
117 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
20 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
138 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
26 |
Percent Of With Atrial Fibrillation |
22 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
22 |
Percent Of With Chronic Kidney Disease |
27 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
71 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
35 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.3586 |