National Provider Identifier [NPI]: |
1427377217 |
Last Name Of The Provider |
FU |
First Name Of The Provider |
JASON |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
|
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
622 W 168TH ST |
Street Address 2 Of The Provider |
PH5-133 STEM |
City Of The Provider |
NEW YORK |
Zip Code Of The Provider |
100323720 |
State Code Of The Provider |
NY |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
49 |
Number Of Services |
153 |
Number Of Medicare Beneficiaries |
99 |
Total Submitted Charge Amount |
337186.4 |
Total Medicare Allowed Amount |
37944.75 |
Total Medicare Payment Amount |
29633.51 |
Total Medicare Standardized Payment Amount |
26033.35 |
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 |
49 |
Number Of Medical Services |
153 |
Number Of Medicare Beneficiaries With Medical Services |
99 |
Total Medical Submitted Charge Amount |
337186.4 |
Total Medical Medicare Allowed Amount |
37944.75 |
Total Medical Medicare Payment Amount |
29633.51 |
Total Medical Medicare Standardized Payment Amount |
26033.35 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
15 |
Number Of Beneficiaries Age 65 to 74 |
34 |
Number Of Beneficiaries Age 75 to 84 |
37 |
Number Of Beneficiaries Age Greater 84 |
13 |
Number Of Female Beneficiaries |
48 |
Number Of Male Beneficiaries |
51 |
Number Of Non Hispanic White Beneficiaries |
70 |
Number Of Black or African American Beneficiaries |
12 |
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 |
38 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
61 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
29 |
Percent Of With Asthma |
20 |
Percent Of With Cancer |
29 |
Percent Of With Heart Failure |
59 |
Percent Of With Chronic Kidney Disease |
41 |
Percent Of With Chronic Obstructive Pulmonary Disease |
29 |
Percent Of With Depression |
36 |
Percent Of With Diabetes |
72 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
72 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
52 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
2.53 |