National Provider Identifier [NPI]: |
1891792693 |
Last Name Of The Provider |
KIM |
First Name Of The Provider |
HYUNG |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
8635 W 3RD ST STE 1070W |
Street Address 2 Of The Provider |
|
City Of The Provider |
LOS ANGELES |
Zip Code Of The Provider |
900486137 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Urology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
78 |
Number Of Services |
699 |
Number Of Medicare Beneficiaries |
235 |
Total Submitted Charge Amount |
431589.5 |
Total Medicare Allowed Amount |
134417.33 |
Total Medicare Payment Amount |
106558.11 |
Total Medicare Standardized Payment Amount |
100176.05 |
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 |
78 |
Number Of Medical Services |
699 |
Number Of Medicare Beneficiaries With Medical Services |
235 |
Total Medical Submitted Charge Amount |
431589.5 |
Total Medical Medicare Allowed Amount |
134417.33 |
Total Medical Medicare Payment Amount |
106558.11 |
Total Medical Medicare Standardized Payment Amount |
100176.05 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
54 |
Number Of Beneficiaries Age 65 to 74 |
125 |
Number Of Beneficiaries Age 75 to 84 |
41 |
Number Of Beneficiaries Age Greater 84 |
15 |
Number Of Female Beneficiaries |
65 |
Number Of Male Beneficiaries |
170 |
Number Of Non Hispanic White Beneficiaries |
143 |
Number Of Black or African American Beneficiaries |
25 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
34 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
143 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
92 |
Percent Of With Atrial Fibrillation |
6 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
34 |
Percent Of With Heart Failure |
23 |
Percent Of With Chronic Kidney Disease |
60 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
43 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
2.6925 |