| National Provider Identifier [NPI]: | 1205898020 |
| Last Name Of The Provider | KISHINEFF |
| First Name Of The Provider | STEPHEN |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 501 S BUENA VISTA ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | BURBANK |
| Zip Code Of The Provider | 915054809 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 36 |
| Number Of Services | 1430 |
| Number Of Medicare Beneficiaries | 942 |
| Total Submitted Charge Amount | 702703 |
| Total Medicare Allowed Amount | 183264.6 |
| Total Medicare Payment Amount | 140986.73 |
| Total Medicare Standardized Payment Amount | 135187.38 |
| 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 | 36 |
| Number Of Medical Services | 1430 |
| Number Of Medicare Beneficiaries With Medical Services | 942 |
| Total Medical Submitted Charge Amount | 702703 |
| Total Medical Medicare Allowed Amount | 183264.6 |
| Total Medical Medicare Payment Amount | 140986.73 |
| Total Medical Medicare Standardized Payment Amount | 135187.38 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 124 |
| Number Of Beneficiaries Age 65 to 74 | 256 |
| Number Of Beneficiaries Age 75 to 84 | 286 |
| Number Of Beneficiaries Age Greater 84 | 276 |
| Number Of Female Beneficiaries | 520 |
| Number Of Male Beneficiaries | 422 |
| Number Of Non Hispanic White Beneficiaries | 687 |
| Number Of Black or African American Beneficiaries | 43 |
| Number Of AsianPacific Islander Beneficiaries | 32 |
| Number Of Hispanic Beneficiaries | 157 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 463 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 479 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 32 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 46 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 37 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 62 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 16 |
| Average HCC Risk Score Of Beneficiaries | 2.285 |