National Provider Identifier [NPI]: |
1689713620 |
Last Name Of The Provider |
JUN |
First Name Of The Provider |
HONG |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
101 3RD AVE SW |
Street Address 2 Of The Provider |
|
City Of The Provider |
MINOT |
Zip Code Of The Provider |
587013880 |
State Code Of The Provider |
ND |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
150 |
Number Of Services |
1134 |
Number Of Medicare Beneficiaries |
373 |
Total Submitted Charge Amount |
725197.78 |
Total Medicare Allowed Amount |
190203.18 |
Total Medicare Payment Amount |
147476.66 |
Total Medicare Standardized Payment Amount |
153317.66 |
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 |
150 |
Number Of Medical Services |
1134 |
Number Of Medicare Beneficiaries With Medical Services |
373 |
Total Medical Submitted Charge Amount |
725197.78 |
Total Medical Medicare Allowed Amount |
190203.18 |
Total Medical Medicare Payment Amount |
147476.66 |
Total Medical Medicare Standardized Payment Amount |
153317.66 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
53 |
Number Of Beneficiaries Age 65 to 74 |
132 |
Number Of Beneficiaries Age 75 to 84 |
120 |
Number Of Beneficiaries Age Greater 84 |
68 |
Number Of Female Beneficiaries |
186 |
Number Of Male Beneficiaries |
187 |
Number Of Non Hispanic White Beneficiaries |
346 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
301 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
72 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
30 |
Percent Of With Chronic Kidney Disease |
43 |
Percent Of With Chronic Obstructive Pulmonary Disease |
29 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
47 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
32 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.8077 |