National Provider Identifier [NPI]: |
1023135266 |
Last Name Of The Provider |
STONEKING |
First Name Of The Provider |
KIM |
Middle Initial Of The Provider |
W |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1718 E KESSLER BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
LONGVIEW |
Zip Code Of The Provider |
986321842 |
State Code Of The Provider |
WA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
37 |
Number Of Services |
1466 |
Number Of Medicare Beneficiaries |
528 |
Total Submitted Charge Amount |
128087.5 |
Total Medicare Allowed Amount |
90389.32 |
Total Medicare Payment Amount |
60280.06 |
Total Medicare Standardized Payment Amount |
64536.66 |
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 |
37 |
Number Of Medical Services |
1466 |
Number Of Medicare Beneficiaries With Medical Services |
528 |
Total Medical Submitted Charge Amount |
128087.5 |
Total Medical Medicare Allowed Amount |
90389.32 |
Total Medical Medicare Payment Amount |
60280.06 |
Total Medical Medicare Standardized Payment Amount |
64536.66 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
87 |
Number Of Beneficiaries Age 65 to 74 |
237 |
Number Of Beneficiaries Age 75 to 84 |
150 |
Number Of Beneficiaries Age Greater 84 |
54 |
Number Of Female Beneficiaries |
270 |
Number Of Male Beneficiaries |
258 |
Number Of Non Hispanic White Beneficiaries |
512 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
427 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
101 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
34 |
Percent Of With Hypertension |
55 |
Percent Of With Ischemic Heart Disease |
24 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
30 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.1404 |