| National Provider Identifier [NPI]: | 1982800603 |
| Last Name Of The Provider | KONA |
| First Name Of The Provider | HIMA |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 145 W 4TH ST |
| Street Address 2 Of The Provider | SUITE 102 |
| City Of The Provider | COOKEVILLE |
| Zip Code Of The Provider | 385012447 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pulmonary Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 39 |
| Number Of Services | 1909 |
| Number Of Medicare Beneficiaries | 485 |
| Total Submitted Charge Amount | 470664.5 |
| Total Medicare Allowed Amount | 179934.45 |
| Total Medicare Payment Amount | 137580.88 |
| Total Medicare Standardized Payment Amount | 147279.38 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 53 |
| Number Of Medicare Beneficiaries With Drug Services | 31 |
| Total Drug Submitted ChargeAmount | 1690 |
| Total Drug Medicare AllowedAmount | 840.68 |
| Total Drug Medicare PaymentAmount | 817.41 |
| Total Drug Medicare Standardized Payment Amount | 817.41 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 35 |
| Number Of Medical Services | 1856 |
| Number Of Medicare Beneficiaries With Medical Services | 485 |
| Total Medical Submitted Charge Amount | 468974.5 |
| Total Medical Medicare Allowed Amount | 179093.77 |
| Total Medical Medicare Payment Amount | 136763.47 |
| Total Medical Medicare Standardized Payment Amount | 146461.97 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 87 |
| Number Of Beneficiaries Age 65 to 74 | 210 |
| Number Of Beneficiaries Age 75 to 84 | 137 |
| Number Of Beneficiaries Age Greater 84 | 51 |
| Number Of Female Beneficiaries | 256 |
| Number Of Male Beneficiaries | 229 |
| Number Of Non Hispanic White Beneficiaries | 474 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 302 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 183 |
| Percent Of With Atrial Fibrillation | 27 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 64 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 75 |
| Percent Of With Depression | 42 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 69 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 13 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 2.2132 |