National Provider Identifier [NPI]: |
1124121686 |
Last Name Of The Provider |
DINH |
First Name Of The Provider |
MONSICHA |
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 |
1329 LUSITANA ST |
Street Address 2 Of The Provider |
SUITE 710 |
City Of The Provider |
HONOLULU |
Zip Code Of The Provider |
968132429 |
State Code Of The Provider |
HI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
17 |
Number Of Services |
408 |
Number Of Medicare Beneficiaries |
92 |
Total Submitted Charge Amount |
65077.52 |
Total Medicare Allowed Amount |
45167.03 |
Total Medicare Payment Amount |
33007.84 |
Total Medicare Standardized Payment Amount |
31045.93 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
28 |
Number Of Medicare Beneficiaries With Drug Services |
27 |
Total Drug Submitted ChargeAmount |
817.86 |
Total Drug Medicare AllowedAmount |
707.98 |
Total Drug Medicare PaymentAmount |
682.04 |
Total Drug Medicare Standardized Payment Amount |
682.04 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
15 |
Number Of Medical Services |
380 |
Number Of Medicare Beneficiaries With Medical Services |
92 |
Total Medical Submitted Charge Amount |
64259.66 |
Total Medical Medicare Allowed Amount |
44459.05 |
Total Medical Medicare Payment Amount |
32325.8 |
Total Medical Medicare Standardized Payment Amount |
30363.89 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
40 |
Number Of Beneficiaries Age 75 to 84 |
27 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
55 |
Number Of Male Beneficiaries |
37 |
Number Of Non Hispanic White Beneficiaries |
32 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
49 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
75 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
17 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
43 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
|
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
32 |
Percent Of With Osteoporosis |
29 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
32 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.9382 |