National Provider Identifier [NPI]: |
1346415072 |
Last Name Of The Provider |
KIM |
First Name Of The Provider |
KYUNGROK |
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 |
20639 KINGSBURY ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
CHATSWORTH |
Zip Code Of The Provider |
913112428 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
56 |
Number Of Services |
574 |
Number Of Medicare Beneficiaries |
292 |
Total Submitted Charge Amount |
584300 |
Total Medicare Allowed Amount |
129977.42 |
Total Medicare Payment Amount |
100860.42 |
Total Medicare Standardized Payment Amount |
98416.91 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
56 |
Number Of Medical Services |
574 |
Number Of Medicare Beneficiaries With Medical Services |
292 |
Total Medical Submitted Charge Amount |
584300 |
Total Medical Medicare Allowed Amount |
129977.42 |
Total Medical Medicare Payment Amount |
100860.42 |
Total Medical Medicare Standardized Payment Amount |
98416.91 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
25 |
Number Of Beneficiaries Age 65 to 74 |
114 |
Number Of Beneficiaries Age 75 to 84 |
113 |
Number Of Beneficiaries Age Greater 84 |
40 |
Number Of Female Beneficiaries |
165 |
Number Of Male Beneficiaries |
127 |
Number Of Non Hispanic White Beneficiaries |
83 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
113 |
Number Of Hispanic Beneficiaries |
64 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
103 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
189 |
Percent Of With Atrial Fibrillation |
22 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
40 |
Percent Of With Chronic Kidney Disease |
43 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
61 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
68 |
Percent Of With Osteoporosis |
17 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
2.2574 |