| National Provider Identifier [NPI]: | 1972545796 |
| Last Name Of The Provider | KONKLE |
| First Name Of The Provider | BARBARA |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 921 TERRY AVE |
| Street Address 2 Of The Provider | PUGET SOUND BLOOD CENTER |
| City Of The Provider | SEATTLE |
| Zip Code Of The Provider | 981041239 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 26 |
| Number Of Services | 94598 |
| Number Of Medicare Beneficiaries | 42 |
| Total Submitted Charge Amount | 1628024.67 |
| Total Medicare Allowed Amount | 1602919.93 |
| Total Medicare Payment Amount | 1256265.41 |
| Total Medicare Standardized Payment Amount | 1259050.51 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 94525 |
| Number Of Medicare Beneficiaries With Drug Services | 21 |
| Total Drug Submitted ChargeAmount | 1620251.27 |
| Total Drug Medicare AllowedAmount | 1599581.88 |
| Total Drug Medicare PaymentAmount | 1253457.19 |
| Total Drug Medicare Standardized Payment Amount | 1253457.19 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 21 |
| Number Of Medical Services | 73 |
| Number Of Medicare Beneficiaries With Medical Services | 25 |
| Total Medical Submitted Charge Amount | 7773.4 |
| Total Medical Medicare Allowed Amount | 3338.05 |
| Total Medical Medicare Payment Amount | 2808.22 |
| Total Medical Medicare Standardized Payment Amount | 5593.32 |
| Average Age Of Beneficiaries | 61 |
| Number Of Beneficiaries Age Less65 | 20 |
| Number Of Beneficiaries Age 65 to 74 | |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 11 |
| Number Of Male Beneficiaries | 31 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | 27 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 15 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 0 |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | |
| Percent Of With Hyperlipidemia | 36 |
| Percent Of With Hypertension | 62 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 0 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 29 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 0 |
| Average HCC Risk Score Of Beneficiaries | 2.5542 |