| National Provider Identifier [NPI]: | 1861716805 |
| Last Name Of The Provider | KOON |
| First Name Of The Provider | SHIRLEY |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 33501 1ST WAY S |
| Street Address 2 Of The Provider | |
| City Of The Provider | FEDERAL WAY |
| Zip Code Of The Provider | 980036208 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 84 |
| Number Of Services | 5938 |
| Number Of Medicare Beneficiaries | 839 |
| Total Submitted Charge Amount | 532610.21 |
| Total Medicare Allowed Amount | 175912.45 |
| Total Medicare Payment Amount | 131495.05 |
| Total Medicare Standardized Payment Amount | 127457.65 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 35 |
| Number Of Drug Services | 4184 |
| Number Of Medicare Beneficiaries With Drug Services | 169 |
| Total Drug Submitted ChargeAmount | 247742.21 |
| Total Drug Medicare AllowedAmount | 87933.74 |
| Total Drug Medicare PaymentAmount | 69140.7 |
| Total Drug Medicare Standardized Payment Amount | 69140.7 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 49 |
| Number Of Medical Services | 1754 |
| Number Of Medicare Beneficiaries With Medical Services | 807 |
| Total Medical Submitted Charge Amount | 284868 |
| Total Medical Medicare Allowed Amount | 87978.71 |
| Total Medical Medicare Payment Amount | 62354.35 |
| Total Medical Medicare Standardized Payment Amount | 58316.95 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 87 |
| Number Of Beneficiaries Age 65 to 74 | 327 |
| Number Of Beneficiaries Age 75 to 84 | 268 |
| Number Of Beneficiaries Age Greater 84 | 157 |
| Number Of Female Beneficiaries | 505 |
| Number Of Male Beneficiaries | 334 |
| Number Of Non Hispanic White Beneficiaries | 721 |
| Number Of Black or African American Beneficiaries | 30 |
| Number Of AsianPacific Islander Beneficiaries | 50 |
| Number Of Hispanic Beneficiaries | 22 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 756 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 83 |
| Percent Of With Atrial Fibrillation | 26 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 59 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.2781 |