National Provider Identifier [NPI]: |
1710900618 |
Last Name Of The Provider |
CHOO |
First Name Of The Provider |
EVELYN |
Middle Initial Of The Provider |
B |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
11370 ANDERSON ST |
Street Address 2 Of The Provider |
STE 2960 |
City Of The Provider |
LOMA LINDA |
Zip Code Of The Provider |
923543450 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pathology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
24 |
Number Of Services |
1150 |
Number Of Medicare Beneficiaries |
443 |
Total Submitted Charge Amount |
203138 |
Total Medicare Allowed Amount |
48505.18 |
Total Medicare Payment Amount |
37532.01 |
Total Medicare Standardized Payment Amount |
29067.6 |
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 |
24 |
Number Of Medical Services |
1150 |
Number Of Medicare Beneficiaries With Medical Services |
443 |
Total Medical Submitted Charge Amount |
203138 |
Total Medical Medicare Allowed Amount |
48505.18 |
Total Medical Medicare Payment Amount |
37532.01 |
Total Medical Medicare Standardized Payment Amount |
29067.6 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
113 |
Number Of Beneficiaries Age 65 to 74 |
183 |
Number Of Beneficiaries Age 75 to 84 |
111 |
Number Of Beneficiaries Age Greater 84 |
36 |
Number Of Female Beneficiaries |
238 |
Number Of Male Beneficiaries |
205 |
Number Of Non Hispanic White Beneficiaries |
271 |
Number Of Black or African American Beneficiaries |
41 |
Number Of AsianPacific Islander Beneficiaries |
26 |
Number Of Hispanic Beneficiaries |
90 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
252 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
191 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
22 |
Percent Of With Heart Failure |
31 |
Percent Of With Chronic Kidney Disease |
37 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
42 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
35 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
2.1654 |