National Provider Identifier [NPI]: |
1457322166 |
Last Name Of The Provider |
SU |
First Name Of The Provider |
YUNGPO |
Middle Initial Of The Provider |
B |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
7500 MERCY RD |
Street Address 2 Of The Provider |
SUITE 1300 |
City Of The Provider |
OMAHA |
Zip Code Of The Provider |
681242319 |
State Code Of The Provider |
NE |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Hematology/Oncology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
121 |
Number Of Services |
121486 |
Number Of Medicare Beneficiaries |
549 |
Total Submitted Charge Amount |
3010316 |
Total Medicare Allowed Amount |
1247517.32 |
Total Medicare Payment Amount |
957929.21 |
Total Medicare Standardized Payment Amount |
962958.11 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
70 |
Number Of Drug Services |
117067 |
Number Of Medicare Beneficiaries With Drug Services |
215 |
Total Drug Submitted ChargeAmount |
2348083 |
Total Drug Medicare AllowedAmount |
970664.25 |
Total Drug Medicare PaymentAmount |
745974.75 |
Total Drug Medicare Standardized Payment Amount |
745974.75 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
51 |
Number Of Medical Services |
4419 |
Number Of Medicare Beneficiaries With Medical Services |
549 |
Total Medical Submitted Charge Amount |
662233 |
Total Medical Medicare Allowed Amount |
276853.07 |
Total Medical Medicare Payment Amount |
211954.46 |
Total Medical Medicare Standardized Payment Amount |
216983.36 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
33 |
Number Of Beneficiaries Age 65 to 74 |
263 |
Number Of Beneficiaries Age 75 to 84 |
194 |
Number Of Beneficiaries Age Greater 84 |
59 |
Number Of Female Beneficiaries |
306 |
Number Of Male Beneficiaries |
243 |
Number Of Non Hispanic White Beneficiaries |
511 |
Number Of Black or African American Beneficiaries |
19 |
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 |
503 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
46 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
4 |
Percent Of With Cancer |
48 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
27 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
25 |
Percent Of With Hyperlipidemia |
45 |
Percent Of With Hypertension |
64 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
2.0791 |