National Provider Identifier [NPI]: |
1285659748 |
Last Name Of The Provider |
SUH |
First Name Of The Provider |
ROBERT |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
10833 LE CONTE AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
LOS ANGELES |
Zip Code Of The Provider |
900953075 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
44 |
Number Of Services |
10185 |
Number Of Medicare Beneficiaries |
2003 |
Total Submitted Charge Amount |
1268052.94 |
Total Medicare Allowed Amount |
224512.11 |
Total Medicare Payment Amount |
172624.51 |
Total Medicare Standardized Payment Amount |
171575.76 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
7138 |
Number Of Medicare Beneficiaries With Drug Services |
70 |
Total Drug Submitted ChargeAmount |
35790 |
Total Drug Medicare AllowedAmount |
1349.02 |
Total Drug Medicare PaymentAmount |
1057.36 |
Total Drug Medicare Standardized Payment Amount |
1057.36 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
41 |
Number Of Medical Services |
3047 |
Number Of Medicare Beneficiaries With Medical Services |
2003 |
Total Medical Submitted Charge Amount |
1232262.94 |
Total Medical Medicare Allowed Amount |
223163.09 |
Total Medical Medicare Payment Amount |
171567.15 |
Total Medical Medicare Standardized Payment Amount |
170518.4 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
345 |
Number Of Beneficiaries Age 65 to 74 |
826 |
Number Of Beneficiaries Age 75 to 84 |
547 |
Number Of Beneficiaries Age Greater 84 |
285 |
Number Of Female Beneficiaries |
1037 |
Number Of Male Beneficiaries |
966 |
Number Of Non Hispanic White Beneficiaries |
1280 |
Number Of Black or African American Beneficiaries |
164 |
Number Of AsianPacific Islander Beneficiaries |
222 |
Number Of Hispanic Beneficiaries |
268 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
1369 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
634 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
29 |
Percent Of With Heart Failure |
34 |
Percent Of With Chronic Kidney Disease |
46 |
Percent Of With Chronic Obstructive Pulmonary Disease |
30 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
52 |
Percent Of With Osteoporosis |
16 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
2.4556 |