National Provider Identifier [NPI]: |
1841482981 |
Last Name Of The Provider |
KWON |
First Name Of The Provider |
MURRAY |
Middle Initial Of The Provider |
H |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
10833 LECONTE AVE |
Street Address 2 Of The Provider |
CHS 62-229 |
City Of The Provider |
LOS ANGELES |
Zip Code Of The Provider |
90095 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiac Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
64 |
Number Of Services |
227 |
Number Of Medicare Beneficiaries |
104 |
Total Submitted Charge Amount |
1211207.5 |
Total Medicare Allowed Amount |
204263.38 |
Total Medicare Payment Amount |
159890.2 |
Total Medicare Standardized Payment Amount |
153315.76 |
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 |
64 |
Number Of Medical Services |
227 |
Number Of Medicare Beneficiaries With Medical Services |
104 |
Total Medical Submitted Charge Amount |
1211207.5 |
Total Medical Medicare Allowed Amount |
204263.38 |
Total Medical Medicare Payment Amount |
159890.2 |
Total Medical Medicare Standardized Payment Amount |
153315.76 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
20 |
Number Of Beneficiaries Age 65 to 74 |
39 |
Number Of Beneficiaries Age 75 to 84 |
30 |
Number Of Beneficiaries Age Greater 84 |
15 |
Number Of Female Beneficiaries |
39 |
Number Of Male Beneficiaries |
65 |
Number Of Non Hispanic White Beneficiaries |
58 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
22 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
64 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
40 |
Percent Of With Atrial Fibrillation |
41 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
73 |
Percent Of With Chronic Kidney Disease |
60 |
Percent Of With Chronic Obstructive Pulmonary Disease |
37 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
54 |
Percent Of With Hyperlipidemia |
74 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
2.3565 |