National Provider Identifier [NPI]: |
1952495954 |
Last Name Of The Provider |
KWON |
First Name Of The Provider |
OKI |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
10313 GEORGIA AVE |
Street Address 2 Of The Provider |
SUITE 209 |
City Of The Provider |
SILVER SPRING |
Zip Code Of The Provider |
209025006 |
State Code Of The Provider |
MD |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
27 |
Number Of Services |
5458 |
Number Of Medicare Beneficiaries |
580 |
Total Submitted Charge Amount |
411805 |
Total Medicare Allowed Amount |
268138.57 |
Total Medicare Payment Amount |
194275.01 |
Total Medicare Standardized Payment Amount |
175994.19 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
1415 |
Number Of Medicare Beneficiaries With Drug Services |
353 |
Total Drug Submitted ChargeAmount |
57960 |
Total Drug Medicare AllowedAmount |
22877.02 |
Total Drug Medicare PaymentAmount |
19221.15 |
Total Drug Medicare Standardized Payment Amount |
19221.15 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
22 |
Number Of Medical Services |
4043 |
Number Of Medicare Beneficiaries With Medical Services |
580 |
Total Medical Submitted Charge Amount |
353845 |
Total Medical Medicare Allowed Amount |
245261.55 |
Total Medical Medicare Payment Amount |
175053.86 |
Total Medical Medicare Standardized Payment Amount |
156773.04 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
36 |
Number Of Beneficiaries Age 65 to 74 |
311 |
Number Of Beneficiaries Age 75 to 84 |
177 |
Number Of Beneficiaries Age Greater 84 |
56 |
Number Of Female Beneficiaries |
309 |
Number Of Male Beneficiaries |
271 |
Number Of Non Hispanic White Beneficiaries |
60 |
Number Of Black or African American Beneficiaries |
95 |
Number Of AsianPacific Islander Beneficiaries |
357 |
Number Of Hispanic Beneficiaries |
23 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
45 |
Number Of Beneficiaries With Medicare Only Entitlement |
386 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
194 |
Percent Of With Atrial Fibrillation |
3 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
7 |
Percent Of With Chronic Kidney Disease |
9 |
Percent Of With Chronic Obstructive Pulmonary Disease |
3 |
Percent Of With Depression |
14 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
17 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
21 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
0.8244 |