National Provider Identifier [NPI]: |
1518074731 |
Last Name Of The Provider |
LIU |
First Name Of The Provider |
JAMES |
Middle Initial Of The Provider |
H |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1730 S SAN GABRIEL BLVD # C |
Street Address 2 Of The Provider |
|
City Of The Provider |
SAN GABRIEL |
Zip Code Of The Provider |
917763928 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
75 |
Number Of Services |
31970 |
Number Of Medicare Beneficiaries |
973 |
Total Submitted Charge Amount |
2962682 |
Total Medicare Allowed Amount |
1982237.62 |
Total Medicare Payment Amount |
1545395.43 |
Total Medicare Standardized Payment Amount |
1366971.03 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
15666 |
Number Of Medicare Beneficiaries With Drug Services |
273 |
Total Drug Submitted ChargeAmount |
113932 |
Total Drug Medicare AllowedAmount |
46138.65 |
Total Drug Medicare PaymentAmount |
36401.31 |
Total Drug Medicare Standardized Payment Amount |
36401.31 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
72 |
Number Of Medical Services |
16304 |
Number Of Medicare Beneficiaries With Medical Services |
973 |
Total Medical Submitted Charge Amount |
2848750 |
Total Medical Medicare Allowed Amount |
1936098.97 |
Total Medical Medicare Payment Amount |
1508994.12 |
Total Medical Medicare Standardized Payment Amount |
1330569.72 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
155 |
Number Of Beneficiaries Age 65 to 74 |
285 |
Number Of Beneficiaries Age 75 to 84 |
297 |
Number Of Beneficiaries Age Greater 84 |
236 |
Number Of Female Beneficiaries |
547 |
Number Of Male Beneficiaries |
426 |
Number Of Non Hispanic White Beneficiaries |
189 |
Number Of Black or African American Beneficiaries |
93 |
Number Of AsianPacific Islander Beneficiaries |
481 |
Number Of Hispanic Beneficiaries |
191 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
154 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
819 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
43 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
62 |
Percent Of With Chronic Kidney Disease |
55 |
Percent Of With Chronic Obstructive Pulmonary Disease |
52 |
Percent Of With Depression |
36 |
Percent Of With Diabetes |
71 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
20 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
69 |
Percent Of With Schizophrenia Other PsychoticDisorders |
25 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
2.8973 |