National Provider Identifier [NPI]: |
1669468757 |
Last Name Of The Provider |
HAN |
First Name Of The Provider |
JAY |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
100 E VALENCIA MESA DR |
Street Address 2 Of The Provider |
SUITE 206 |
City Of The Provider |
FULLERTON |
Zip Code Of The Provider |
928353813 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
59 |
Number Of Services |
6859 |
Number Of Medicare Beneficiaries |
1784 |
Total Submitted Charge Amount |
1275065.07 |
Total Medicare Allowed Amount |
482466.26 |
Total Medicare Payment Amount |
366239.68 |
Total Medicare Standardized Payment Amount |
323000.37 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
415 |
Number Of Medicare Beneficiaries With Drug Services |
117 |
Total Drug Submitted ChargeAmount |
207610 |
Total Drug Medicare AllowedAmount |
21373.85 |
Total Drug Medicare PaymentAmount |
16653.85 |
Total Drug Medicare Standardized Payment Amount |
16653.85 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
56 |
Number Of Medical Services |
6444 |
Number Of Medicare Beneficiaries With Medical Services |
1783 |
Total Medical Submitted Charge Amount |
1067455.07 |
Total Medical Medicare Allowed Amount |
461092.41 |
Total Medical Medicare Payment Amount |
349585.83 |
Total Medical Medicare Standardized Payment Amount |
306346.52 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
103 |
Number Of Beneficiaries Age 65 to 74 |
582 |
Number Of Beneficiaries Age 75 to 84 |
630 |
Number Of Beneficiaries Age Greater 84 |
469 |
Number Of Female Beneficiaries |
917 |
Number Of Male Beneficiaries |
867 |
Number Of Non Hispanic White Beneficiaries |
1372 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
188 |
Number Of Hispanic Beneficiaries |
164 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
33 |
Number Of Beneficiaries With Medicare Only Entitlement |
1484 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
300 |
Percent Of With Atrial Fibrillation |
39 |
Percent Of With Alzheimers Disease or Dementia |
16 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
33 |
Percent Of With Chronic Kidney Disease |
36 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
49 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
1.6665 |