National Provider Identifier [NPI]: |
1013967504 |
Last Name Of The Provider |
KIM |
First Name Of The Provider |
SUNG |
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 |
1300 N VERMONT AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
LOS ANGELES |
Zip Code Of The Provider |
900276005 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
62 |
Number Of Services |
343 |
Number Of Medicare Beneficiaries |
317 |
Total Submitted Charge Amount |
364537.5 |
Total Medicare Allowed Amount |
88486.84 |
Total Medicare Payment Amount |
69319.5 |
Total Medicare Standardized Payment Amount |
66830.12 |
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 |
62 |
Number Of Medical Services |
343 |
Number Of Medicare Beneficiaries With Medical Services |
317 |
Total Medical Submitted Charge Amount |
364537.5 |
Total Medical Medicare Allowed Amount |
88486.84 |
Total Medical Medicare Payment Amount |
69319.5 |
Total Medical Medicare Standardized Payment Amount |
66830.12 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
39 |
Number Of Beneficiaries Age 65 to 74 |
110 |
Number Of Beneficiaries Age 75 to 84 |
100 |
Number Of Beneficiaries Age Greater 84 |
68 |
Number Of Female Beneficiaries |
184 |
Number Of Male Beneficiaries |
133 |
Number Of Non Hispanic White Beneficiaries |
133 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
83 |
Number Of Hispanic Beneficiaries |
69 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
34 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
283 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
39 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
43 |
Percent Of With Chronic Kidney Disease |
48 |
Percent Of With Chronic Obstructive Pulmonary Disease |
30 |
Percent Of With Depression |
35 |
Percent Of With Diabetes |
68 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
70 |
Percent Of With Osteoporosis |
22 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
66 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
2.8484 |