| National Provider Identifier [NPI]: | 1881887867 |
| Last Name Of The Provider | DART |
| First Name Of The Provider | KIMI |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2410 CROCKETT DR |
| Street Address 2 Of The Provider | SUITE B |
| City Of The Provider | BROWNWOOD |
| Zip Code Of The Provider | 768015906 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Otolaryngology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 145 |
| Number Of Services | 6196.5 |
| Number Of Medicare Beneficiaries | 405 |
| Total Submitted Charge Amount | 250711.81 |
| Total Medicare Allowed Amount | 180163.69 |
| Total Medicare Payment Amount | 132791.57 |
| Total Medicare Standardized Payment Amount | 138853.68 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 1240.5 |
| Number Of Medicare Beneficiaries With Drug Services | 116 |
| Total Drug Submitted ChargeAmount | 6165.94 |
| Total Drug Medicare AllowedAmount | 1648.78 |
| Total Drug Medicare PaymentAmount | 1367.64 |
| Total Drug Medicare Standardized Payment Amount | 1367.64 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 134 |
| Number Of Medical Services | 4956 |
| Number Of Medicare Beneficiaries With Medical Services | 405 |
| Total Medical Submitted Charge Amount | 244545.87 |
| Total Medical Medicare Allowed Amount | 178514.91 |
| Total Medical Medicare Payment Amount | 131423.93 |
| Total Medical Medicare Standardized Payment Amount | 137486.04 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 68 |
| Number Of Beneficiaries Age 65 to 74 | 177 |
| Number Of Beneficiaries Age 75 to 84 | 115 |
| Number Of Beneficiaries Age Greater 84 | 45 |
| Number Of Female Beneficiaries | 238 |
| Number Of Male Beneficiaries | 167 |
| Number Of Non Hispanic White Beneficiaries | 361 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 31 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 283 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 122 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 40 |
| Percent Of With Hypertension | 61 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0162 |