National Provider Identifier [NPI]: |
1710093182 |
Last Name Of The Provider |
KIM |
First Name Of The Provider |
HANS |
Middle Initial Of The Provider |
H |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4220 W 3RD ST |
Street Address 2 Of The Provider |
SUITE 206 |
City Of The Provider |
LOS ANGELES |
Zip Code Of The Provider |
900203450 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Ophthalmology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
62 |
Number Of Services |
11750 |
Number Of Medicare Beneficiaries |
1181 |
Total Submitted Charge Amount |
2661835 |
Total Medicare Allowed Amount |
1631469.12 |
Total Medicare Payment Amount |
1247986.95 |
Total Medicare Standardized Payment Amount |
1061741.27 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
646 |
Number Of Medicare Beneficiaries With Drug Services |
145 |
Total Drug Submitted ChargeAmount |
166480 |
Total Drug Medicare AllowedAmount |
69617.8 |
Total Drug Medicare PaymentAmount |
54493.06 |
Total Drug Medicare Standardized Payment Amount |
54493.06 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
58 |
Number Of Medical Services |
11104 |
Number Of Medicare Beneficiaries With Medical Services |
1181 |
Total Medical Submitted Charge Amount |
2495355 |
Total Medical Medicare Allowed Amount |
1561851.32 |
Total Medical Medicare Payment Amount |
1193493.89 |
Total Medical Medicare Standardized Payment Amount |
1007248.21 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
29 |
Number Of Beneficiaries Age 65 to 74 |
494 |
Number Of Beneficiaries Age 75 to 84 |
491 |
Number Of Beneficiaries Age Greater 84 |
167 |
Number Of Female Beneficiaries |
737 |
Number Of Male Beneficiaries |
444 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
1074 |
Number Of Hispanic Beneficiaries |
29 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
62 |
Number Of Beneficiaries With Medicare Only Entitlement |
160 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
1021 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
5 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
10 |
Percent Of With Diabetes |
66 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
42 |
Percent Of With Osteoporosis |
22 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
57 |
Percent Of With Schizophrenia Other PsychoticDisorders |
1 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.3309 |