National Provider Identifier [NPI]: |
1093977399 |
Last Name Of The Provider |
TANHEHCO |
First Name Of The Provider |
YVETTE |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
630 WEST 168TH ST |
Street Address 2 Of The Provider |
PH 1564W |
City Of The Provider |
NY |
Zip Code Of The Provider |
10032 |
State Code Of The Provider |
NY |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pathology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
6 |
Number Of Services |
146 |
Number Of Medicare Beneficiaries |
117 |
Total Submitted Charge Amount |
38802 |
Total Medicare Allowed Amount |
10221.17 |
Total Medicare Payment Amount |
7755.87 |
Total Medicare Standardized Payment Amount |
6968.11 |
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 |
6 |
Number Of Medical Services |
146 |
Number Of Medicare Beneficiaries With Medical Services |
117 |
Total Medical Submitted Charge Amount |
38802 |
Total Medical Medicare Allowed Amount |
10221.17 |
Total Medical Medicare Payment Amount |
7755.87 |
Total Medical Medicare Standardized Payment Amount |
6968.11 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
41 |
Number Of Beneficiaries Age 65 to 74 |
30 |
Number Of Beneficiaries Age 75 to 84 |
29 |
Number Of Beneficiaries Age Greater 84 |
17 |
Number Of Female Beneficiaries |
68 |
Number Of Male Beneficiaries |
49 |
Number Of Non Hispanic White Beneficiaries |
59 |
Number Of Black or African American Beneficiaries |
25 |
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 |
66 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
51 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
20 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
62 |
Percent Of With Chronic Kidney Disease |
62 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
48 |
Percent Of With Hyperlipidemia |
49 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
64 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
16 |
Average HCC Risk Score Of Beneficiaries |
3.7862 |