National Provider Identifier [NPI]: |
1841385663 |
Last Name Of The Provider |
CHUNG |
First Name Of The Provider |
TAI |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6936 WINTON BLOUNT BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
MONTGOMERY |
Zip Code Of The Provider |
361173555 |
State Code Of The Provider |
AL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Orthopedic Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
55 |
Number Of Services |
503 |
Number Of Medicare Beneficiaries |
136 |
Total Submitted Charge Amount |
148939 |
Total Medicare Allowed Amount |
70902.77 |
Total Medicare Payment Amount |
53986.02 |
Total Medicare Standardized Payment Amount |
60753.93 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
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Number Of Drug Services |
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Number Of Medicare Beneficiaries With Drug Services |
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Total Drug Submitted ChargeAmount |
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Total Drug Medicare AllowedAmount |
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Total Drug Medicare PaymentAmount |
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Total Drug Medicare Standardized Payment Amount |
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Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
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Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
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Total Medical Medicare Allowed Amount |
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Total Medical Medicare Payment Amount |
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Total Medical Medicare Standardized Payment Amount |
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Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
18 |
Number Of Beneficiaries Age 65 to 74 |
56 |
Number Of Beneficiaries Age 75 to 84 |
38 |
Number Of Beneficiaries Age Greater 84 |
24 |
Number Of Female Beneficiaries |
78 |
Number Of Male Beneficiaries |
58 |
Number Of Non Hispanic White Beneficiaries |
101 |
Number Of Black or African American Beneficiaries |
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Number Of AsianPacific Islander Beneficiaries |
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Number Of Hispanic Beneficiaries |
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Number Of American Indian Alaska Native Beneficiaries |
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Number Of Beneficiaries With Race Not Else where Classified |
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Number Of Beneficiaries With Medicare Only Entitlement |
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Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
|
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
13 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
15 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
49 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
51 |
Percent Of With Schizophrenia Other PsychoticDisorders |
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Percent Of With Stroke |
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Average HCC Risk Score Of Beneficiaries |
0.8915 |