National Provider Identifier [NPI]: |
1144241696 |
Last Name Of The Provider |
KIM |
First Name Of The Provider |
MIN |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
8300 COLLIER BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
NAPLES |
Zip Code Of The Provider |
34114 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
92 |
Number Of Services |
2174 |
Number Of Medicare Beneficiaries |
782 |
Total Submitted Charge Amount |
256279 |
Total Medicare Allowed Amount |
137984.55 |
Total Medicare Payment Amount |
97384.3 |
Total Medicare Standardized Payment Amount |
93084.4 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
546 |
Number Of Medicare Beneficiaries With Drug Services |
120 |
Total Drug Submitted ChargeAmount |
4963 |
Total Drug Medicare AllowedAmount |
962.35 |
Total Drug Medicare PaymentAmount |
774.21 |
Total Drug Medicare Standardized Payment Amount |
774.21 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
84 |
Number Of Medical Services |
1628 |
Number Of Medicare Beneficiaries With Medical Services |
782 |
Total Medical Submitted Charge Amount |
251316 |
Total Medical Medicare Allowed Amount |
137022.2 |
Total Medical Medicare Payment Amount |
96610.09 |
Total Medical Medicare Standardized Payment Amount |
92310.19 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
20 |
Number Of Beneficiaries Age 65 to 74 |
413 |
Number Of Beneficiaries Age 75 to 84 |
264 |
Number Of Beneficiaries Age Greater 84 |
85 |
Number Of Female Beneficiaries |
454 |
Number Of Male Beneficiaries |
328 |
Number Of Non Hispanic White Beneficiaries |
749 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
13 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
771 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
11 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
14 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
14 |
Percent Of With Diabetes |
19 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
59 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
0.9778 |