National Provider Identifier [NPI]: |
1710170246 |
Last Name Of The Provider |
CHUNG |
First Name Of The Provider |
ANNE |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
104 ENDICOTT ST |
Street Address 2 Of The Provider |
SUITE LL05 |
City Of The Provider |
DANVERS |
Zip Code Of The Provider |
019233623 |
State Code Of The Provider |
MA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
60 |
Number Of Services |
635 |
Number Of Medicare Beneficiaries |
376 |
Total Submitted Charge Amount |
163597 |
Total Medicare Allowed Amount |
47092.57 |
Total Medicare Payment Amount |
34311.79 |
Total Medicare Standardized Payment Amount |
33695.82 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
15 |
Number Of Drug Services |
111 |
Number Of Medicare Beneficiaries With Drug Services |
71 |
Total Drug Submitted ChargeAmount |
1403 |
Total Drug Medicare AllowedAmount |
766 |
Total Drug Medicare PaymentAmount |
733.51 |
Total Drug Medicare Standardized Payment Amount |
733.51 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
45 |
Number Of Medical Services |
524 |
Number Of Medicare Beneficiaries With Medical Services |
376 |
Total Medical Submitted Charge Amount |
162194 |
Total Medical Medicare Allowed Amount |
46326.57 |
Total Medical Medicare Payment Amount |
33578.28 |
Total Medical Medicare Standardized Payment Amount |
32962.31 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
68 |
Number Of Beneficiaries Age 65 to 74 |
149 |
Number Of Beneficiaries Age 75 to 84 |
108 |
Number Of Beneficiaries Age Greater 84 |
51 |
Number Of Female Beneficiaries |
242 |
Number Of Male Beneficiaries |
134 |
Number Of Non Hispanic White Beneficiaries |
358 |
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 |
274 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
102 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
25 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
25 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
64 |
Percent Of With Ischemic Heart Disease |
36 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.3108 |