National Provider Identifier [NPI]: |
1336184316 |
Last Name Of The Provider |
NGO |
First Name Of The Provider |
NHANHAU |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
12692 BROOKHURST STREET |
Street Address 2 Of The Provider |
|
City Of The Provider |
GARDEN GROVE |
Zip Code Of The Provider |
92840 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
18 |
Number Of Services |
2126 |
Number Of Medicare Beneficiaries |
216 |
Total Submitted Charge Amount |
174580 |
Total Medicare Allowed Amount |
136550.09 |
Total Medicare Payment Amount |
104732.08 |
Total Medicare Standardized Payment Amount |
94410.98 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
410 |
Number Of Medicare Beneficiaries With Drug Services |
153 |
Total Drug Submitted ChargeAmount |
9140 |
Total Drug Medicare AllowedAmount |
6286.45 |
Total Drug Medicare PaymentAmount |
6113.29 |
Total Drug Medicare Standardized Payment Amount |
6113.29 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
14 |
Number Of Medical Services |
1716 |
Number Of Medicare Beneficiaries With Medical Services |
216 |
Total Medical Submitted Charge Amount |
165440 |
Total Medical Medicare Allowed Amount |
130263.64 |
Total Medical Medicare Payment Amount |
98618.79 |
Total Medical Medicare Standardized Payment Amount |
88297.69 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
13 |
Number Of Beneficiaries Age 65 to 74 |
118 |
Number Of Beneficiaries Age 75 to 84 |
65 |
Number Of Beneficiaries Age Greater 84 |
20 |
Number Of Female Beneficiaries |
152 |
Number Of Male Beneficiaries |
64 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
20 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
5 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
7 |
Percent Of With Depression |
6 |
Percent Of With Diabetes |
50 |
Percent Of With Hyperlipidemia |
74 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.002 |