National Provider Identifier [NPI]: |
1821289158 |
Last Name Of The Provider |
WARD |
First Name Of The Provider |
TUAN |
Middle Initial Of The Provider |
N |
Credentials Of The Provider |
DO |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
400 N PEPPER AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
COLTON |
Zip Code Of The Provider |
923241801 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
18 |
Number Of Services |
1112 |
Number Of Medicare Beneficiaries |
316 |
Total Submitted Charge Amount |
147233.82 |
Total Medicare Allowed Amount |
103997.31 |
Total Medicare Payment Amount |
81304.15 |
Total Medicare Standardized Payment Amount |
79310.45 |
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 |
18 |
Number Of Medical Services |
1112 |
Number Of Medicare Beneficiaries With Medical Services |
316 |
Total Medical Submitted Charge Amount |
147233.82 |
Total Medical Medicare Allowed Amount |
103997.31 |
Total Medical Medicare Payment Amount |
81304.15 |
Total Medical Medicare Standardized Payment Amount |
79310.45 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
59 |
Number Of Beneficiaries Age 65 to 74 |
82 |
Number Of Beneficiaries Age 75 to 84 |
92 |
Number Of Beneficiaries Age Greater 84 |
83 |
Number Of Female Beneficiaries |
163 |
Number Of Male Beneficiaries |
153 |
Number Of Non Hispanic White Beneficiaries |
237 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
56 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
188 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
128 |
Percent Of With Atrial Fibrillation |
28 |
Percent Of With Alzheimers Disease or Dementia |
36 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
47 |
Percent Of With Chronic Kidney Disease |
53 |
Percent Of With Chronic Obstructive Pulmonary Disease |
40 |
Percent Of With Depression |
39 |
Percent Of With Diabetes |
47 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
59 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
19 |
Average HCC Risk Score Of Beneficiaries |
2.475 |