National Provider Identifier [NPI]: |
1780604298 |
Last Name Of The Provider |
YANG |
First Name Of The Provider |
OTTO |
Middle Initial Of The Provider |
O |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
200 MEDICAL PLAZA |
Street Address 2 Of The Provider |
#365,530,420,120 |
City Of The Provider |
LOS ANGELES |
Zip Code Of The Provider |
900953075 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Infectious Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
11 |
Number Of Services |
132 |
Number Of Medicare Beneficiaries |
53 |
Total Submitted Charge Amount |
48377 |
Total Medicare Allowed Amount |
15948.39 |
Total Medicare Payment Amount |
12430.03 |
Total Medicare Standardized Payment Amount |
11697.69 |
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 |
11 |
Number Of Medical Services |
132 |
Number Of Medicare Beneficiaries With Medical Services |
53 |
Total Medical Submitted Charge Amount |
48377 |
Total Medical Medicare Allowed Amount |
15948.39 |
Total Medical Medicare Payment Amount |
12430.03 |
Total Medical Medicare Standardized Payment Amount |
11697.69 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
16 |
Number Of Beneficiaries Age 75 to 84 |
18 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
26 |
Number Of Male Beneficiaries |
27 |
Number Of Non Hispanic White Beneficiaries |
33 |
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 |
29 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
24 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
28 |
Percent Of With Asthma |
|
Percent Of With Cancer |
26 |
Percent Of With Heart Failure |
42 |
Percent Of With Chronic Kidney Disease |
66 |
Percent Of With Chronic Obstructive Pulmonary Disease |
30 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
51 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
2.3446 |