| National Provider Identifier [NPI]: | 1487737474 |
| Last Name Of The Provider | CUESTA |
| First Name Of The Provider | KIMBERLY |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 100 E CARROLL ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | SALISBURY |
| Zip Code Of The Provider | 218015422 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pathology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 31 |
| Number Of Services | 4448 |
| Number Of Medicare Beneficiaries | 1929 |
| Total Submitted Charge Amount | 595098 |
| Total Medicare Allowed Amount | 167381.32 |
| Total Medicare Payment Amount | 128903.28 |
| Total Medicare Standardized Payment Amount | 106469.66 |
| 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 | 4448 |
| Number Of Medicare Beneficiaries With Medical Services | 1929 |
| Total Medical Submitted Charge Amount | 595098 |
| Total Medical Medicare Allowed Amount | 167381.32 |
| Total Medical Medicare Payment Amount | 128903.28 |
| Total Medical Medicare Standardized Payment Amount | 106469.66 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 226 |
| Number Of Beneficiaries Age 65 to 74 | 911 |
| Number Of Beneficiaries Age 75 to 84 | 584 |
| Number Of Beneficiaries Age Greater 84 | 208 |
| Number Of Female Beneficiaries | 1018 |
| Number Of Male Beneficiaries | 911 |
| Number Of Non Hispanic White Beneficiaries | 1664 |
| Number Of Black or African American Beneficiaries | 218 |
| 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 | 22 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1627 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 302 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.343 |