| National Provider Identifier [NPI]: | 1972607216 |
| Last Name Of The Provider | KITTLESON |
| First Name Of The Provider | MICHELLE |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD PHD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 100 UCLA MEDICAL PLAZA |
| Street Address 2 Of The Provider | #630 |
| City Of The Provider | LOS ANGELES |
| Zip Code Of The Provider | 900956988 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 40 |
| Number Of Services | 3451 |
| Number Of Medicare Beneficiaries | 1203 |
| Total Submitted Charge Amount | 1307710 |
| Total Medicare Allowed Amount | 436262.81 |
| Total Medicare Payment Amount | 330077.79 |
| Total Medicare Standardized Payment Amount | 303455.76 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 11 |
| Number Of Medicare Beneficiaries With Drug Services | 11 |
| Total Drug Submitted ChargeAmount | 232 |
| Total Drug Medicare AllowedAmount | 102.97 |
| Total Drug Medicare PaymentAmount | 92 |
| Total Drug Medicare Standardized Payment Amount | 92 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 37 |
| Number Of Medical Services | 3440 |
| Number Of Medicare Beneficiaries With Medical Services | 1203 |
| Total Medical Submitted Charge Amount | 1307478 |
| Total Medical Medicare Allowed Amount | 436159.84 |
| Total Medical Medicare Payment Amount | 329985.79 |
| Total Medical Medicare Standardized Payment Amount | 303363.76 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 235 |
| Number Of Beneficiaries Age 65 to 74 | 535 |
| Number Of Beneficiaries Age 75 to 84 | 322 |
| Number Of Beneficiaries Age Greater 84 | 111 |
| Number Of Female Beneficiaries | 467 |
| Number Of Male Beneficiaries | 736 |
| Number Of Non Hispanic White Beneficiaries | 792 |
| Number Of Black or African American Beneficiaries | 107 |
| Number Of AsianPacific Islander Beneficiaries | 129 |
| Number Of Hispanic Beneficiaries | 124 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 864 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 339 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 52 |
| Percent Of With Chronic Kidney Disease | 45 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 48 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 70 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 2.3765 |