National Provider Identifier [NPI]: |
1457388308 |
Last Name Of The Provider |
CHOI |
First Name Of The Provider |
TONY |
Middle Initial Of The Provider |
G |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2701 S BRISTOL STREET |
Street Address 2 Of The Provider |
|
City Of The Provider |
SANTA ANA |
Zip Code Of The Provider |
927040240 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
29 |
Number Of Services |
582 |
Number Of Medicare Beneficiaries |
417 |
Total Submitted Charge Amount |
276740 |
Total Medicare Allowed Amount |
73828.19 |
Total Medicare Payment Amount |
56325.91 |
Total Medicare Standardized Payment Amount |
53530.18 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
29 |
Number Of Medical Services |
582 |
Number Of Medicare Beneficiaries With Medical Services |
417 |
Total Medical Submitted Charge Amount |
276740 |
Total Medical Medicare Allowed Amount |
73828.19 |
Total Medical Medicare Payment Amount |
56325.91 |
Total Medical Medicare Standardized Payment Amount |
53530.18 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
104 |
Number Of Beneficiaries Age 65 to 74 |
119 |
Number Of Beneficiaries Age 75 to 84 |
103 |
Number Of Beneficiaries Age Greater 84 |
91 |
Number Of Female Beneficiaries |
218 |
Number Of Male Beneficiaries |
199 |
Number Of Non Hispanic White Beneficiaries |
118 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
61 |
Number Of Hispanic Beneficiaries |
207 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
82 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
335 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
43 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
40 |
Percent Of With Chronic Kidney Disease |
49 |
Percent Of With Chronic Obstructive Pulmonary Disease |
31 |
Percent Of With Depression |
42 |
Percent Of With Diabetes |
56 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
60 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
28 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
2.4561 |