National Provider Identifier [NPI]: |
1790868545 |
Last Name Of The Provider |
CHOI |
First Name Of The Provider |
SEAN |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
D.P.M., M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
15366 11TH ST STE A |
Street Address 2 Of The Provider |
|
City Of The Provider |
VICTORVILLE |
Zip Code Of The Provider |
923953726 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Podiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
51 |
Number Of Services |
3108 |
Number Of Medicare Beneficiaries |
444 |
Total Submitted Charge Amount |
387980 |
Total Medicare Allowed Amount |
186658.28 |
Total Medicare Payment Amount |
137180.48 |
Total Medicare Standardized Payment Amount |
138245.72 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
1 |
Number Of Drug Services |
24 |
Number Of Medicare Beneficiaries With Drug Services |
18 |
Total Drug Submitted ChargeAmount |
120 |
Total Drug Medicare AllowedAmount |
40.72 |
Total Drug Medicare PaymentAmount |
29.08 |
Total Drug Medicare Standardized Payment Amount |
29.08 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
50 |
Number Of Medical Services |
3084 |
Number Of Medicare Beneficiaries With Medical Services |
444 |
Total Medical Submitted Charge Amount |
387860 |
Total Medical Medicare Allowed Amount |
186617.56 |
Total Medical Medicare Payment Amount |
137151.4 |
Total Medical Medicare Standardized Payment Amount |
138216.64 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
74 |
Number Of Beneficiaries Age 65 to 74 |
172 |
Number Of Beneficiaries Age 75 to 84 |
119 |
Number Of Beneficiaries Age Greater 84 |
79 |
Number Of Female Beneficiaries |
231 |
Number Of Male Beneficiaries |
213 |
Number Of Non Hispanic White Beneficiaries |
263 |
Number Of Black or African American Beneficiaries |
55 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
109 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
284 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
160 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
18 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
36 |
Percent Of With Chronic Kidney Disease |
51 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
18 |
Percent Of With Diabetes |
72 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
49 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
2.1297 |