| National Provider Identifier [NPI]: | 1538363171 |
| Last Name Of The Provider | KITAGAWA |
| First Name Of The Provider | KEVIN |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 417 STATE ST |
| Street Address 2 Of The Provider | SUITE 439 |
| City Of The Provider | BANGOR |
| Zip Code Of The Provider | 044016635 |
| State Code Of The Provider | ME |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pathology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 31 |
| Number Of Services | 5659 |
| Number Of Medicare Beneficiaries | 2965 |
| Total Submitted Charge Amount | 503507 |
| Total Medicare Allowed Amount | 196628.44 |
| Total Medicare Payment Amount | 139952.78 |
| Total Medicare Standardized Payment Amount | 112661.93 |
| 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 | 31 |
| Number Of Medical Services | 5659 |
| Number Of Medicare Beneficiaries With Medical Services | 2965 |
| Total Medical Submitted Charge Amount | 503507 |
| Total Medical Medicare Allowed Amount | 196628.44 |
| Total Medical Medicare Payment Amount | 139952.78 |
| Total Medical Medicare Standardized Payment Amount | 112661.93 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 363 |
| Number Of Beneficiaries Age 65 to 74 | 1114 |
| Number Of Beneficiaries Age 75 to 84 | 1025 |
| Number Of Beneficiaries Age Greater 84 | 463 |
| Number Of Female Beneficiaries | 1463 |
| Number Of Male Beneficiaries | 1502 |
| Number Of Non Hispanic White Beneficiaries | 2828 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 70 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 12 |
| Number Of Beneficiaries With Race Not Else where Classified | 42 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2107 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 858 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 62 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.0902 |