National Provider Identifier [NPI]: |
1225106693 |
Last Name Of The Provider |
OH |
First Name Of The Provider |
HEE |
Middle Initial Of The Provider |
Y |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1433 W MERCED AVE STE 207 |
Street Address 2 Of The Provider |
|
City Of The Provider |
WEST COVINA |
Zip Code Of The Provider |
917903402 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
17 |
Number Of Services |
583 |
Number Of Medicare Beneficiaries |
101 |
Total Submitted Charge Amount |
71580 |
Total Medicare Allowed Amount |
54349.65 |
Total Medicare Payment Amount |
42180.24 |
Total Medicare Standardized Payment Amount |
38915.74 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
54 |
Number Of Medicare Beneficiaries With Drug Services |
50 |
Total Drug Submitted ChargeAmount |
2210 |
Total Drug Medicare AllowedAmount |
820.62 |
Total Drug Medicare PaymentAmount |
802.98 |
Total Drug Medicare Standardized Payment Amount |
802.98 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
15 |
Number Of Medical Services |
529 |
Number Of Medicare Beneficiaries With Medical Services |
101 |
Total Medical Submitted Charge Amount |
69370 |
Total Medical Medicare Allowed Amount |
53529.03 |
Total Medical Medicare Payment Amount |
41377.26 |
Total Medical Medicare Standardized Payment Amount |
38112.76 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
33 |
Number Of Beneficiaries Age 75 to 84 |
45 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
69 |
Number Of Male Beneficiaries |
32 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
0 |
Number Of AsianPacific Islander Beneficiaries |
84 |
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 |
25 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
76 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
16 |
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
32 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
|
Percent Of With Diabetes |
46 |
Percent Of With Hyperlipidemia |
47 |
Percent Of With Hypertension |
66 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
19 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.4773 |