National Provider Identifier [NPI]: |
1477583763 |
Last Name Of The Provider |
CHEN |
First Name Of The Provider |
JUN |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4240 INTERNATIONAL PKWY |
Street Address 2 Of The Provider |
STE. 154 |
City Of The Provider |
CARROLLTON |
Zip Code Of The Provider |
75007 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nephrology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
42 |
Number Of Services |
18006 |
Number Of Medicare Beneficiaries |
669 |
Total Submitted Charge Amount |
774557 |
Total Medicare Allowed Amount |
322581.76 |
Total Medicare Payment Amount |
246141.78 |
Total Medicare Standardized Payment Amount |
257287.15 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
14627 |
Number Of Medicare Beneficiaries With Drug Services |
54 |
Total Drug Submitted ChargeAmount |
170470 |
Total Drug Medicare AllowedAmount |
41996.99 |
Total Drug Medicare PaymentAmount |
32399.05 |
Total Drug Medicare Standardized Payment Amount |
32399.05 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
37 |
Number Of Medical Services |
3379 |
Number Of Medicare Beneficiaries With Medical Services |
669 |
Total Medical Submitted Charge Amount |
604087 |
Total Medical Medicare Allowed Amount |
280584.77 |
Total Medical Medicare Payment Amount |
213742.73 |
Total Medical Medicare Standardized Payment Amount |
224888.1 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
98 |
Number Of Beneficiaries Age 65 to 74 |
224 |
Number Of Beneficiaries Age 75 to 84 |
218 |
Number Of Beneficiaries Age Greater 84 |
129 |
Number Of Female Beneficiaries |
347 |
Number Of Male Beneficiaries |
322 |
Number Of Non Hispanic White Beneficiaries |
449 |
Number Of Black or African American Beneficiaries |
85 |
Number Of AsianPacific Islander Beneficiaries |
57 |
Number Of Hispanic Beneficiaries |
58 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
510 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
159 |
Percent Of With Atrial Fibrillation |
26 |
Percent Of With Alzheimers Disease or Dementia |
26 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
54 |
Percent Of With Chronic Kidney Disease |
75 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
36 |
Percent Of With Diabetes |
57 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
60 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
52 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
16 |
Average HCC Risk Score Of Beneficiaries |
2.9869 |