National Provider Identifier [NPI]: |
1891953766 |
Last Name Of The Provider |
DO |
First Name Of The Provider |
DANG |
Middle Initial Of The Provider |
H |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
17700 SE 272ND ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
COVINGTON |
Zip Code Of The Provider |
980424951 |
State Code Of The Provider |
WA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
39 |
Number Of Services |
891 |
Number Of Medicare Beneficiaries |
266 |
Total Submitted Charge Amount |
145483 |
Total Medicare Allowed Amount |
76883.23 |
Total Medicare Payment Amount |
51122.41 |
Total Medicare Standardized Payment Amount |
49802.77 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
10 |
Number Of Drug Services |
103 |
Number Of Medicare Beneficiaries With Drug Services |
66 |
Total Drug Submitted ChargeAmount |
3806 |
Total Drug Medicare AllowedAmount |
3050.53 |
Total Drug Medicare PaymentAmount |
2977.82 |
Total Drug Medicare Standardized Payment Amount |
2977.82 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
29 |
Number Of Medical Services |
788 |
Number Of Medicare Beneficiaries With Medical Services |
266 |
Total Medical Submitted Charge Amount |
141677 |
Total Medical Medicare Allowed Amount |
73832.7 |
Total Medical Medicare Payment Amount |
48144.59 |
Total Medical Medicare Standardized Payment Amount |
46824.95 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
45 |
Number Of Beneficiaries Age 65 to 74 |
123 |
Number Of Beneficiaries Age 75 to 84 |
66 |
Number Of Beneficiaries Age Greater 84 |
32 |
Number Of Female Beneficiaries |
136 |
Number Of Male Beneficiaries |
130 |
Number Of Non Hispanic White Beneficiaries |
228 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
15 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
216 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
50 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
62 |
Percent Of With Ischemic Heart Disease |
21 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0283 |