National Provider Identifier [NPI]: |
1154301646 |
Last Name Of The Provider |
KYLE |
First Name Of The Provider |
MARK |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
10666 N TORREY PINES RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
LA JOLLA |
Zip Code Of The Provider |
920371027 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
18 |
Number Of Services |
600 |
Number Of Medicare Beneficiaries |
219 |
Total Submitted Charge Amount |
164847 |
Total Medicare Allowed Amount |
72053.24 |
Total Medicare Payment Amount |
55702.14 |
Total Medicare Standardized Payment Amount |
54202.71 |
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 |
18 |
Number Of Medical Services |
600 |
Number Of Medicare Beneficiaries With Medical Services |
219 |
Total Medical Submitted Charge Amount |
164847 |
Total Medical Medicare Allowed Amount |
72053.24 |
Total Medical Medicare Payment Amount |
55702.14 |
Total Medical Medicare Standardized Payment Amount |
54202.71 |
Average Age Of Beneficiaries |
78 |
Number Of Beneficiaries Age Less65 |
20 |
Number Of Beneficiaries Age 65 to 74 |
56 |
Number Of Beneficiaries Age 75 to 84 |
71 |
Number Of Beneficiaries Age Greater 84 |
72 |
Number Of Female Beneficiaries |
127 |
Number Of Male Beneficiaries |
92 |
Number Of Non Hispanic White Beneficiaries |
179 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
17 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
181 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
38 |
Percent Of With Atrial Fibrillation |
30 |
Percent Of With Alzheimers Disease or Dementia |
21 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
20 |
Percent Of With Heart Failure |
44 |
Percent Of With Chronic Kidney Disease |
60 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
39 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
53 |
Percent Of With Osteoporosis |
21 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
52 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
14 |
Average HCC Risk Score Of Beneficiaries |
2.4136 |