| National Provider Identifier [NPI]: | 1457463481 |
| Last Name Of The Provider | KALISH |
| First Name Of The Provider | GRACE |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 533 S 336TH ST STE C |
| Street Address 2 Of The Provider | |
| City Of The Provider | FEDERAL WAY |
| Zip Code Of The Provider | 980036329 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 107 |
| Number Of Services | 3128 |
| Number Of Medicare Beneficiaries | 1803 |
| Total Submitted Charge Amount | 243731.65 |
| Total Medicare Allowed Amount | 77642.2 |
| Total Medicare Payment Amount | 64339.57 |
| Total Medicare Standardized Payment Amount | 62249.8 |
| Drug Suppress Indicator | * |
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| Medical SuppressIndicator | # |
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| Number Of Medicare Beneficiaries With Medical Services | |
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| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 209 |
| Number Of Beneficiaries Age 65 to 74 | 800 |
| Number Of Beneficiaries Age 75 to 84 | 578 |
| Number Of Beneficiaries Age Greater 84 | 216 |
| Number Of Female Beneficiaries | 1493 |
| Number Of Male Beneficiaries | 310 |
| Number Of Non Hispanic White Beneficiaries | 1467 |
| Number Of Black or African American Beneficiaries | 84 |
| Number Of AsianPacific Islander Beneficiaries | 139 |
| Number Of Hispanic Beneficiaries | 47 |
| Number Of American Indian Alaska Native Beneficiaries | 12 |
| Number Of Beneficiaries With Race Not Else where Classified | 54 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1426 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 377 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 60 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.3101 |