National Provider Identifier [NPI]: |
1942305438 |
Last Name Of The Provider |
MOON |
First Name Of The Provider |
SUNG |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1310 SOUTHERN AVE SE |
Street Address 2 Of The Provider |
|
City Of The Provider |
WASHINGTON |
Zip Code Of The Provider |
200324623 |
State Code Of The Provider |
DC |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
22 |
Number Of Services |
83 |
Number Of Medicare Beneficiaries |
73 |
Total Submitted Charge Amount |
58537.5 |
Total Medicare Allowed Amount |
16218.24 |
Total Medicare Payment Amount |
12613.54 |
Total Medicare Standardized Payment Amount |
11715.83 |
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 |
22 |
Number Of Medical Services |
83 |
Number Of Medicare Beneficiaries With Medical Services |
73 |
Total Medical Submitted Charge Amount |
58537.5 |
Total Medical Medicare Allowed Amount |
16218.24 |
Total Medical Medicare Payment Amount |
12613.54 |
Total Medical Medicare Standardized Payment Amount |
11715.83 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
23 |
Number Of Beneficiaries Age 65 to 74 |
30 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
43 |
Number Of Male Beneficiaries |
30 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
|
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 |
13 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
60 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
38 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
64 |
Percent Of With Chronic Kidney Disease |
75 |
Percent Of With Chronic Obstructive Pulmonary Disease |
29 |
Percent Of With Depression |
16 |
Percent Of With Diabetes |
68 |
Percent Of With Hyperlipidemia |
45 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
63 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
15 |
Percent Of With Stroke |
22 |
Average HCC Risk Score Of Beneficiaries |
3.8678 |