National Provider Identifier [NPI]: |
1801968771 |
Last Name Of The Provider |
CHUNG |
First Name Of The Provider |
THOMAS |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
904 7TH AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
SEATTLE |
Zip Code Of The Provider |
981041132 |
State Code Of The Provider |
WA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physical Medicine and Rehabilitation |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
32 |
Number Of Services |
694 |
Number Of Medicare Beneficiaries |
170 |
Total Submitted Charge Amount |
123104.36 |
Total Medicare Allowed Amount |
48223.49 |
Total Medicare Payment Amount |
36332.94 |
Total Medicare Standardized Payment Amount |
32305.86 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
284 |
Number Of Medicare Beneficiaries With Drug Services |
15 |
Total Drug Submitted ChargeAmount |
1388.36 |
Total Drug Medicare AllowedAmount |
882.46 |
Total Drug Medicare PaymentAmount |
691.84 |
Total Drug Medicare Standardized Payment Amount |
691.84 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
30 |
Number Of Medical Services |
410 |
Number Of Medicare Beneficiaries With Medical Services |
170 |
Total Medical Submitted Charge Amount |
121716 |
Total Medical Medicare Allowed Amount |
47341.03 |
Total Medical Medicare Payment Amount |
35641.1 |
Total Medical Medicare Standardized Payment Amount |
31614.02 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
28 |
Number Of Beneficiaries Age 65 to 74 |
74 |
Number Of Beneficiaries Age 75 to 84 |
52 |
Number Of Beneficiaries Age Greater 84 |
16 |
Number Of Female Beneficiaries |
99 |
Number Of Male Beneficiaries |
71 |
Number Of Non Hispanic White Beneficiaries |
138 |
Number Of Black or African American Beneficiaries |
16 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
144 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
26 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
8 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
8 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
16 |
Percent Of With Diabetes |
18 |
Percent Of With Hyperlipidemia |
39 |
Percent Of With Hypertension |
45 |
Percent Of With Ischemic Heart Disease |
25 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
51 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1291 |