| National Provider Identifier [NPI]: | 1679653869 |
| Last Name Of The Provider | KIRSCH |
| First Name Of The Provider | HENRY |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 9808 VENICE BLVD |
| Street Address 2 Of The Provider | SUITE 503 |
| City Of The Provider | CULVER CITY |
| Zip Code Of The Provider | 902322732 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 26 |
| Number Of Services | 1057 |
| Number Of Medicare Beneficiaries | 245 |
| Total Submitted Charge Amount | 225750 |
| Total Medicare Allowed Amount | 88951.11 |
| Total Medicare Payment Amount | 67579.9 |
| Total Medicare Standardized Payment Amount | 62799.59 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 103 |
| Number Of Medicare Beneficiaries With Drug Services | 81 |
| Total Drug Submitted ChargeAmount | 5480 |
| Total Drug Medicare AllowedAmount | 3763.07 |
| Total Drug Medicare PaymentAmount | 3681.25 |
| Total Drug Medicare Standardized Payment Amount | 3681.25 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 21 |
| Number Of Medical Services | 954 |
| Number Of Medicare Beneficiaries With Medical Services | 245 |
| Total Medical Submitted Charge Amount | 220270 |
| Total Medical Medicare Allowed Amount | 85188.04 |
| Total Medical Medicare Payment Amount | 63898.65 |
| Total Medical Medicare Standardized Payment Amount | 59118.34 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 42 |
| Number Of Beneficiaries Age 65 to 74 | 67 |
| Number Of Beneficiaries Age 75 to 84 | 82 |
| Number Of Beneficiaries Age Greater 84 | 54 |
| Number Of Female Beneficiaries | 166 |
| Number Of Male Beneficiaries | 79 |
| Number Of Non Hispanic White Beneficiaries | 59 |
| Number Of Black or African American Beneficiaries | 58 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 98 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 85 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 160 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 42 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 60 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.5809 |