National Provider Identifier [NPI]: |
1285858639 |
Last Name Of The Provider |
CHUNG |
First Name Of The Provider |
JASON |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3100 E FLETCHER AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
TAMPA |
Zip Code Of The Provider |
336134613 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
22 |
Number Of Services |
299 |
Number Of Medicare Beneficiaries |
210 |
Total Submitted Charge Amount |
72508.44 |
Total Medicare Allowed Amount |
42254.91 |
Total Medicare Payment Amount |
32776 |
Total Medicare Standardized Payment Amount |
31859.96 |
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 |
22 |
Number Of Medical Services |
299 |
Number Of Medicare Beneficiaries With Medical Services |
210 |
Total Medical Submitted Charge Amount |
72508.44 |
Total Medical Medicare Allowed Amount |
42254.91 |
Total Medical Medicare Payment Amount |
32776 |
Total Medical Medicare Standardized Payment Amount |
31859.96 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
31 |
Number Of Beneficiaries Age 65 to 74 |
100 |
Number Of Beneficiaries Age 75 to 84 |
56 |
Number Of Beneficiaries Age Greater 84 |
23 |
Number Of Female Beneficiaries |
133 |
Number Of Male Beneficiaries |
77 |
Number Of Non Hispanic White Beneficiaries |
193 |
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 |
184 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
26 |
Percent Of With Atrial Fibrillation |
5 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
6 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
74 |
Percent Of With Hypertension |
72 |
Percent Of With Ischemic Heart Disease |
36 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
60 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.2418 |