National Provider Identifier [NPI]: |
1043307754 |
Last Name Of The Provider |
PANG |
First Name Of The Provider |
GLENN |
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 |
2226 LILIHA ST |
Street Address 2 Of The Provider |
#405 |
City Of The Provider |
HONOLULU |
Zip Code Of The Provider |
96817 |
State Code Of The Provider |
HI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Gastroenterology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
19 |
Number Of Services |
974 |
Number Of Medicare Beneficiaries |
300 |
Total Submitted Charge Amount |
305347.13 |
Total Medicare Allowed Amount |
124561.65 |
Total Medicare Payment Amount |
87830.47 |
Total Medicare Standardized Payment Amount |
90596.21 |
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 |
19 |
Number Of Medical Services |
974 |
Number Of Medicare Beneficiaries With Medical Services |
300 |
Total Medical Submitted Charge Amount |
305347.13 |
Total Medical Medicare Allowed Amount |
124561.65 |
Total Medical Medicare Payment Amount |
87830.47 |
Total Medical Medicare Standardized Payment Amount |
90596.21 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
13 |
Number Of Beneficiaries Age 65 to 74 |
136 |
Number Of Beneficiaries Age 75 to 84 |
105 |
Number Of Beneficiaries Age Greater 84 |
46 |
Number Of Female Beneficiaries |
143 |
Number Of Male Beneficiaries |
157 |
Number Of Non Hispanic White Beneficiaries |
26 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
216 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
39 |
Number Of Beneficiaries With Medicare Only Entitlement |
284 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
16 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
24 |
Percent Of With Chronic Obstructive Pulmonary Disease |
6 |
Percent Of With Depression |
6 |
Percent Of With Diabetes |
45 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
35 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
31 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1363 |