National Provider Identifier [NPI]: |
1679670939 |
Last Name Of The Provider |
CHINN |
First Name Of The Provider |
HERBERT |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1329 LUSITANA ST |
Street Address 2 Of The Provider |
#108 |
City Of The Provider |
HONOLULU |
Zip Code Of The Provider |
96813 |
State Code Of The Provider |
HI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Urology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
70 |
Number Of Services |
2527 |
Number Of Medicare Beneficiaries |
608 |
Total Submitted Charge Amount |
635856.32 |
Total Medicare Allowed Amount |
286525.89 |
Total Medicare Payment Amount |
206920.81 |
Total Medicare Standardized Payment Amount |
206221.65 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
518 |
Number Of Medicare Beneficiaries With Drug Services |
23 |
Total Drug Submitted ChargeAmount |
102166.6 |
Total Drug Medicare AllowedAmount |
30892.09 |
Total Drug Medicare PaymentAmount |
23527.52 |
Total Drug Medicare Standardized Payment Amount |
23527.52 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
67 |
Number Of Medical Services |
2009 |
Number Of Medicare Beneficiaries With Medical Services |
608 |
Total Medical Submitted Charge Amount |
533689.72 |
Total Medical Medicare Allowed Amount |
255633.8 |
Total Medical Medicare Payment Amount |
183393.29 |
Total Medical Medicare Standardized Payment Amount |
182694.13 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
16 |
Number Of Beneficiaries Age 65 to 74 |
260 |
Number Of Beneficiaries Age 75 to 84 |
231 |
Number Of Beneficiaries Age Greater 84 |
101 |
Number Of Female Beneficiaries |
106 |
Number Of Male Beneficiaries |
502 |
Number Of Non Hispanic White Beneficiaries |
76 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
403 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
94 |
Number Of Beneficiaries With Medicare Only Entitlement |
573 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
35 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
27 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
32 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
6 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
35 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
23 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.1161 |