National Provider Identifier [NPI]: |
1427093806 |
Last Name Of The Provider |
RHIM |
First Name Of The Provider |
SANG |
Middle Initial Of The Provider |
Y |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
212 WASHINGTON HEIGHTS MEDICAL CENTER |
Street Address 2 Of The Provider |
|
City Of The Provider |
WESTMINSTER |
Zip Code Of The Provider |
21157 |
State Code Of The Provider |
MD |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
7 |
Number Of Services |
271 |
Number Of Medicare Beneficiaries |
77 |
Total Submitted Charge Amount |
17166.7 |
Total Medicare Allowed Amount |
16347.62 |
Total Medicare Payment Amount |
10795.92 |
Total Medicare Standardized Payment Amount |
14434.4 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
1 |
Number Of Drug Services |
15 |
Number Of Medicare Beneficiaries With Drug Services |
15 |
Total Drug Submitted ChargeAmount |
450 |
Total Drug Medicare AllowedAmount |
180.6 |
Total Drug Medicare PaymentAmount |
177 |
Total Drug Medicare Standardized Payment Amount |
177 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
6 |
Number Of Medical Services |
256 |
Number Of Medicare Beneficiaries With Medical Services |
77 |
Total Medical Submitted Charge Amount |
16716.7 |
Total Medical Medicare Allowed Amount |
16167.02 |
Total Medical Medicare Payment Amount |
10618.92 |
Total Medical Medicare Standardized Payment Amount |
14257.4 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
47 |
Number Of Beneficiaries Age 75 to 84 |
19 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
38 |
Number Of Male Beneficiaries |
39 |
Number Of Non Hispanic White Beneficiaries |
60 |
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 |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
|
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
|
Percent Of With Diabetes |
21 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
62 |
Percent Of With Ischemic Heart Disease |
14 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
29 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.7411 |