National Provider Identifier [NPI]: |
1750370458 |
Last Name Of The Provider |
HO |
First Name Of The Provider |
HUY |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
300 FIR ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
SAN DIEGO |
Zip Code Of The Provider |
921012327 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
21 |
Number Of Services |
408 |
Number Of Medicare Beneficiaries |
110 |
Total Submitted Charge Amount |
73956 |
Total Medicare Allowed Amount |
32927.09 |
Total Medicare Payment Amount |
21733.78 |
Total Medicare Standardized Payment Amount |
20990.02 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
48 |
Number Of Medicare Beneficiaries With Drug Services |
25 |
Total Drug Submitted ChargeAmount |
3539 |
Total Drug Medicare AllowedAmount |
1690.87 |
Total Drug Medicare PaymentAmount |
1643.43 |
Total Drug Medicare Standardized Payment Amount |
1643.43 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
13 |
Number Of Medical Services |
360 |
Number Of Medicare Beneficiaries With Medical Services |
110 |
Total Medical Submitted Charge Amount |
70417 |
Total Medical Medicare Allowed Amount |
31236.22 |
Total Medical Medicare Payment Amount |
20090.35 |
Total Medical Medicare Standardized Payment Amount |
19346.59 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
30 |
Number Of Beneficiaries Age 65 to 74 |
48 |
Number Of Beneficiaries Age 75 to 84 |
21 |
Number Of Beneficiaries Age Greater 84 |
11 |
Number Of Female Beneficiaries |
39 |
Number Of Male Beneficiaries |
71 |
Number Of Non Hispanic White Beneficiaries |
62 |
Number Of Black or African American Beneficiaries |
19 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
16 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
69 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
41 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
32 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
15 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
55 |
Percent Of With Ischemic Heart Disease |
22 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
30 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.2014 |