| National Provider Identifier [NPI]: | 1770508533 |
| Last Name Of The Provider | SUSKIEWICZ |
| First Name Of The Provider | KAREN |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 370 DISTEL CIRCLE |
| Street Address 2 Of The Provider | PAMF |
| City Of The Provider | LOS ALTOS |
| Zip Code Of The Provider | 94022 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 21 |
| Number Of Services | 506 |
| Number Of Medicare Beneficiaries | 166 |
| Total Submitted Charge Amount | 101703 |
| Total Medicare Allowed Amount | 49211.12 |
| Total Medicare Payment Amount | 34749.83 |
| Total Medicare Standardized Payment Amount | 29912.36 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 82 |
| Number Of Medicare Beneficiaries With Drug Services | 61 |
| Total Drug Submitted ChargeAmount | 5517 |
| Total Drug Medicare AllowedAmount | 5310.18 |
| Total Drug Medicare PaymentAmount | 5203.41 |
| Total Drug Medicare Standardized Payment Amount | 5203.41 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 15 |
| Number Of Medical Services | 424 |
| Number Of Medicare Beneficiaries With Medical Services | 166 |
| Total Medical Submitted Charge Amount | 96186 |
| Total Medical Medicare Allowed Amount | 43900.94 |
| Total Medical Medicare Payment Amount | 29546.42 |
| Total Medical Medicare Standardized Payment Amount | 24708.95 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 86 |
| Number Of Beneficiaries Age 75 to 84 | 52 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 121 |
| Number Of Male Beneficiaries | 45 |
| Number Of Non Hispanic White Beneficiaries | 138 |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 8 |
| Percent Of With Chronic Kidney Disease | 11 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 11 |
| Percent Of With Diabetes | 13 |
| Percent Of With Hyperlipidemia | 44 |
| Percent Of With Hypertension | 45 |
| Percent Of With Ischemic Heart Disease | 13 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 28 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.7614 |