National Provider Identifier [NPI]: |
1386658656 |
Last Name Of The Provider |
CHAO |
First Name Of The Provider |
SAMUEL |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
9500 EUCLID AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
CLEVELAND |
Zip Code Of The Provider |
441950001 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Radiation Oncology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
42 |
Number Of Services |
2031 |
Number Of Medicare Beneficiaries |
256 |
Total Submitted Charge Amount |
1728551 |
Total Medicare Allowed Amount |
195353.2 |
Total Medicare Payment Amount |
152095.05 |
Total Medicare Standardized Payment Amount |
147857.54 |
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 |
42 |
Number Of Medical Services |
2031 |
Number Of Medicare Beneficiaries With Medical Services |
256 |
Total Medical Submitted Charge Amount |
1728551 |
Total Medical Medicare Allowed Amount |
195353.2 |
Total Medical Medicare Payment Amount |
152095.05 |
Total Medical Medicare Standardized Payment Amount |
147857.54 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
46 |
Number Of Beneficiaries Age 65 to 74 |
121 |
Number Of Beneficiaries Age 75 to 84 |
75 |
Number Of Beneficiaries Age Greater 84 |
14 |
Number Of Female Beneficiaries |
123 |
Number Of Male Beneficiaries |
133 |
Number Of Non Hispanic White Beneficiaries |
218 |
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 |
207 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
49 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
50 |
Percent Of With Heart Failure |
21 |
Percent Of With Chronic Kidney Disease |
27 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.8598 |