National Provider Identifier [NPI]: |
1477606549 |
Last Name Of The Provider |
KIM |
First Name Of The Provider |
ANATOLE |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
406 S 30TH AVE |
Street Address 2 Of The Provider |
SUITE 101 |
City Of The Provider |
YAKIMA |
Zip Code Of The Provider |
989023713 |
State Code Of The Provider |
WA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
51 |
Number Of Services |
3024 |
Number Of Medicare Beneficiaries |
1346 |
Total Submitted Charge Amount |
402062 |
Total Medicare Allowed Amount |
204106.55 |
Total Medicare Payment Amount |
152839.39 |
Total Medicare Standardized Payment Amount |
154684 |
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 |
51 |
Number Of Medical Services |
3024 |
Number Of Medicare Beneficiaries With Medical Services |
1346 |
Total Medical Submitted Charge Amount |
402062 |
Total Medical Medicare Allowed Amount |
204106.55 |
Total Medical Medicare Payment Amount |
152839.39 |
Total Medical Medicare Standardized Payment Amount |
154684 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
104 |
Number Of Beneficiaries Age 65 to 74 |
401 |
Number Of Beneficiaries Age 75 to 84 |
488 |
Number Of Beneficiaries Age Greater 84 |
353 |
Number Of Female Beneficiaries |
655 |
Number Of Male Beneficiaries |
691 |
Number Of Non Hispanic White Beneficiaries |
1185 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
100 |
Number Of American Indian Alaska Native Beneficiaries |
36 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
1077 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
269 |
Percent Of With Atrial Fibrillation |
38 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
51 |
Percent Of With Chronic Kidney Disease |
38 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.6453 |