National Provider Identifier [NPI]: |
1649265596 |
Last Name Of The Provider |
CHA |
First Name Of The Provider |
EUNG |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
25 RIVIERA BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
LAKE HAVASU CITY |
Zip Code Of The Provider |
864035694 |
State Code Of The Provider |
AZ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Orthopedic Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
125 |
Number Of Services |
3968 |
Number Of Medicare Beneficiaries |
509 |
Total Submitted Charge Amount |
1078949 |
Total Medicare Allowed Amount |
409536.26 |
Total Medicare Payment Amount |
311050.92 |
Total Medicare Standardized Payment Amount |
315447.12 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
1570 |
Number Of Medicare Beneficiaries With Drug Services |
131 |
Total Drug Submitted ChargeAmount |
18008 |
Total Drug Medicare AllowedAmount |
3730.06 |
Total Drug Medicare PaymentAmount |
2845.45 |
Total Drug Medicare Standardized Payment Amount |
2845.45 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
118 |
Number Of Medical Services |
2398 |
Number Of Medicare Beneficiaries With Medical Services |
509 |
Total Medical Submitted Charge Amount |
1060941 |
Total Medical Medicare Allowed Amount |
405806.2 |
Total Medical Medicare Payment Amount |
308205.47 |
Total Medical Medicare Standardized Payment Amount |
312601.67 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
38 |
Number Of Beneficiaries Age 65 to 74 |
248 |
Number Of Beneficiaries Age 75 to 84 |
170 |
Number Of Beneficiaries Age Greater 84 |
53 |
Number Of Female Beneficiaries |
286 |
Number Of Male Beneficiaries |
223 |
Number Of Non Hispanic White Beneficiaries |
474 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
20 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
467 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
42 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
68 |
Percent Of With Hypertension |
72 |
Percent Of With Ischemic Heart Disease |
38 |
Percent Of With Osteoporosis |
17 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
71 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.1025 |