National Provider Identifier [NPI]: |
1912018789 |
Last Name Of The Provider |
TON |
First Name Of The Provider |
THOMAS |
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 |
14221 EUCLID ST |
Street Address 2 Of The Provider |
SUITE H |
City Of The Provider |
GARDEN GROVE |
Zip Code Of The Provider |
928434991 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
17 |
Number Of Services |
174 |
Number Of Medicare Beneficiaries |
77 |
Total Submitted Charge Amount |
13002.85 |
Total Medicare Allowed Amount |
11013.19 |
Total Medicare Payment Amount |
6400.85 |
Total Medicare Standardized Payment Amount |
6311.68 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
24 |
Number Of Medicare Beneficiaries With Drug Services |
23 |
Total Drug Submitted ChargeAmount |
996 |
Total Drug Medicare AllowedAmount |
657.03 |
Total Drug Medicare PaymentAmount |
643.87 |
Total Drug Medicare Standardized Payment Amount |
643.87 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
14 |
Number Of Medical Services |
150 |
Number Of Medicare Beneficiaries With Medical Services |
77 |
Total Medical Submitted Charge Amount |
12006.85 |
Total Medical Medicare Allowed Amount |
10356.16 |
Total Medical Medicare Payment Amount |
5756.98 |
Total Medical Medicare Standardized Payment Amount |
5667.81 |
Average Age Of Beneficiaries |
65 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
66 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
0 |
Number Of Female Beneficiaries |
46 |
Number Of Male Beneficiaries |
31 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
34 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
60 |
Percent Of With Ischemic Heart Disease |
17 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
21 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8933 |