| National Provider Identifier [NPI]: | 1013151919 |
| Last Name Of The Provider | PARK |
| First Name Of The Provider | BRENDA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | DO |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1550 N 115TH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | SEATTLE |
| Zip Code Of The Provider | 981338401 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 43 |
| Number Of Services | 935 |
| Number Of Medicare Beneficiaries | 508 |
| Total Submitted Charge Amount | 466603 |
| Total Medicare Allowed Amount | 95126.15 |
| Total Medicare Payment Amount | 73876.55 |
| Total Medicare Standardized Payment Amount | 75209.7 |
| 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 | 43 |
| Number Of Medical Services | 935 |
| Number Of Medicare Beneficiaries With Medical Services | 508 |
| Total Medical Submitted Charge Amount | 466603 |
| Total Medical Medicare Allowed Amount | 95126.15 |
| Total Medical Medicare Payment Amount | 73876.55 |
| Total Medical Medicare Standardized Payment Amount | 75209.7 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 195 |
| Number Of Beneficiaries Age 65 to 74 | 113 |
| Number Of Beneficiaries Age 75 to 84 | 110 |
| Number Of Beneficiaries Age Greater 84 | 90 |
| Number Of Female Beneficiaries | 291 |
| Number Of Male Beneficiaries | 217 |
| Number Of Non Hispanic White Beneficiaries | 358 |
| Number Of Black or African American Beneficiaries | 64 |
| Number Of AsianPacific Islander Beneficiaries | 36 |
| Number Of Hispanic Beneficiaries | 31 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 266 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 242 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 17 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 31 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 42 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 17 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.6528 |