| National Provider Identifier [NPI]: | 1457482432 |
| Last Name Of The Provider | PARK |
| First Name Of The Provider | JOSEPH |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | M D |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2727 W OLYMPIC BLVD |
| Street Address 2 Of The Provider | 113 |
| City Of The Provider | LOS ANGELES |
| Zip Code Of The Provider | 900062637 |
| 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 | 19 |
| Number Of Services | 4107 |
| Number Of Medicare Beneficiaries | 376 |
| Total Submitted Charge Amount | 310550 |
| Total Medicare Allowed Amount | 269532.31 |
| Total Medicare Payment Amount | 192852.91 |
| Total Medicare Standardized Payment Amount | 176717.96 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 697 |
| Number Of Medicare Beneficiaries With Drug Services | 168 |
| Total Drug Submitted ChargeAmount | 6260 |
| Total Drug Medicare AllowedAmount | 1392.8 |
| Total Drug Medicare PaymentAmount | 1049.54 |
| Total Drug Medicare Standardized Payment Amount | 1049.54 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 14 |
| Number Of Medical Services | 3410 |
| Number Of Medicare Beneficiaries With Medical Services | 376 |
| Total Medical Submitted Charge Amount | 304290 |
| Total Medical Medicare Allowed Amount | 268139.51 |
| Total Medical Medicare Payment Amount | 191803.37 |
| Total Medical Medicare Standardized Payment Amount | 175668.42 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 15 |
| Number Of Beneficiaries Age 65 to 74 | 195 |
| Number Of Beneficiaries Age 75 to 84 | 122 |
| Number Of Beneficiaries Age Greater 84 | 44 |
| Number Of Female Beneficiaries | 210 |
| Number Of Male Beneficiaries | 166 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 355 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 43 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 333 |
| Percent Of With Atrial Fibrillation | 4 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 3 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 8 |
| Percent Of With Diabetes | 54 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 58 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.3458 |