National Provider Identifier [NPI]: |
1689627838 |
Last Name Of The Provider |
CHOU |
First Name Of The Provider |
ERIC |
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 |
501 WASHINGTON ST |
Street Address 2 Of The Provider |
STE 510 |
City Of The Provider |
SAN DIEGO |
Zip Code Of The Provider |
921032231 |
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 |
172 |
Number Of Services |
7093 |
Number Of Medicare Beneficiaries |
2213 |
Total Submitted Charge Amount |
1807994.42 |
Total Medicare Allowed Amount |
298622.65 |
Total Medicare Payment Amount |
221805.89 |
Total Medicare Standardized Payment Amount |
215626.78 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
9 |
Number Of Drug Services |
2916 |
Number Of Medicare Beneficiaries With Drug Services |
153 |
Total Drug Submitted ChargeAmount |
32459.85 |
Total Drug Medicare AllowedAmount |
5130.66 |
Total Drug Medicare PaymentAmount |
4019.66 |
Total Drug Medicare Standardized Payment Amount |
4019.66 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
163 |
Number Of Medical Services |
4177 |
Number Of Medicare Beneficiaries With Medical Services |
2213 |
Total Medical Submitted Charge Amount |
1775534.57 |
Total Medical Medicare Allowed Amount |
293491.99 |
Total Medical Medicare Payment Amount |
217786.23 |
Total Medical Medicare Standardized Payment Amount |
211607.12 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
461 |
Number Of Beneficiaries Age 65 to 74 |
786 |
Number Of Beneficiaries Age 75 to 84 |
586 |
Number Of Beneficiaries Age Greater 84 |
380 |
Number Of Female Beneficiaries |
1175 |
Number Of Male Beneficiaries |
1038 |
Number Of Non Hispanic White Beneficiaries |
1465 |
Number Of Black or African American Beneficiaries |
247 |
Number Of AsianPacific Islander Beneficiaries |
126 |
Number Of Hispanic Beneficiaries |
330 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
1257 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
956 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
20 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
37 |
Percent Of With Chronic Kidney Disease |
39 |
Percent Of With Chronic Obstructive Pulmonary Disease |
24 |
Percent Of With Depression |
36 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
47 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
2.0166 |