National Provider Identifier [NPI]: |
1821069287 |
Last Name Of The Provider |
ZHAO |
First Name Of The Provider |
ZHONG |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
640 JACKSON ST |
Street Address 2 Of The Provider |
MC21110Q |
City Of The Provider |
SAINT PAUL |
Zip Code Of The Provider |
551012502 |
State Code Of The Provider |
MN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
23 |
Number Of Services |
657 |
Number Of Medicare Beneficiaries |
295 |
Total Submitted Charge Amount |
186903 |
Total Medicare Allowed Amount |
69688.89 |
Total Medicare Payment Amount |
53489.84 |
Total Medicare Standardized Payment Amount |
55955.65 |
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 |
23 |
Number Of Medical Services |
657 |
Number Of Medicare Beneficiaries With Medical Services |
295 |
Total Medical Submitted Charge Amount |
186903 |
Total Medical Medicare Allowed Amount |
69688.89 |
Total Medical Medicare Payment Amount |
53489.84 |
Total Medical Medicare Standardized Payment Amount |
55955.65 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
94 |
Number Of Beneficiaries Age 65 to 74 |
73 |
Number Of Beneficiaries Age 75 to 84 |
72 |
Number Of Beneficiaries Age Greater 84 |
56 |
Number Of Female Beneficiaries |
155 |
Number Of Male Beneficiaries |
140 |
Number Of Non Hispanic White Beneficiaries |
239 |
Number Of Black or African American Beneficiaries |
34 |
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 |
168 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
127 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
18 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
37 |
Percent Of With Chronic Kidney Disease |
54 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
45 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
51 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
2.039 |