National Provider Identifier [NPI]: |
1699978247 |
Last Name Of The Provider |
KIM |
First Name Of The Provider |
NAE-HWA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1100 9TH AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
SEATTLE |
Zip Code Of The Provider |
981012756 |
State Code Of The Provider |
WA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Urology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
22 |
Number Of Services |
1401 |
Number Of Medicare Beneficiaries |
423 |
Total Submitted Charge Amount |
193558 |
Total Medicare Allowed Amount |
71069.17 |
Total Medicare Payment Amount |
51022.08 |
Total Medicare Standardized Payment Amount |
48220.16 |
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 |
22 |
Number Of Medical Services |
1401 |
Number Of Medicare Beneficiaries With Medical Services |
423 |
Total Medical Submitted Charge Amount |
193558 |
Total Medical Medicare Allowed Amount |
71069.17 |
Total Medical Medicare Payment Amount |
51022.08 |
Total Medical Medicare Standardized Payment Amount |
48220.16 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
35 |
Number Of Beneficiaries Age 65 to 74 |
165 |
Number Of Beneficiaries Age 75 to 84 |
142 |
Number Of Beneficiaries Age Greater 84 |
81 |
Number Of Female Beneficiaries |
196 |
Number Of Male Beneficiaries |
227 |
Number Of Non Hispanic White Beneficiaries |
363 |
Number Of Black or African American Beneficiaries |
17 |
Number Of AsianPacific Islander Beneficiaries |
18 |
Number Of Hispanic Beneficiaries |
12 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
370 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
53 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
28 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
45 |
Percent Of With Hypertension |
55 |
Percent Of With Ischemic Heart Disease |
32 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.3053 |