| National Provider Identifier [NPI]: | 1427098086 |
| Last Name Of The Provider | BLACK |
| First Name Of The Provider | KAREN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 22930 CRENSHAW BLVD. |
| Street Address 2 Of The Provider | #A |
| City Of The Provider | TORRRANCE |
| Zip Code Of The Provider | 905053048 |
| 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 | 14 |
| Number Of Services | 1021 |
| Number Of Medicare Beneficiaries | 204 |
| Total Submitted Charge Amount | 134225 |
| Total Medicare Allowed Amount | 91357.85 |
| Total Medicare Payment Amount | 65256.62 |
| Total Medicare Standardized Payment Amount | 60138.54 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 73 |
| Number Of Medicare Beneficiaries With Drug Services | 66 |
| Total Drug Submitted ChargeAmount | 1895 |
| Total Drug Medicare AllowedAmount | 887.53 |
| Total Drug Medicare PaymentAmount | 859.95 |
| Total Drug Medicare Standardized Payment Amount | 859.95 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 11 |
| Number Of Medical Services | 948 |
| Number Of Medicare Beneficiaries With Medical Services | 204 |
| Total Medical Submitted Charge Amount | 132330 |
| Total Medical Medicare Allowed Amount | 90470.32 |
| Total Medical Medicare Payment Amount | 64396.67 |
| Total Medical Medicare Standardized Payment Amount | 59278.59 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 106 |
| Number Of Beneficiaries Age 75 to 84 | 59 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 174 |
| Number Of Male Beneficiaries | 30 |
| Number Of Non Hispanic White Beneficiaries | 170 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 14 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| 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 | 6 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 8 |
| Percent Of With Chronic Kidney Disease | 11 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 6 |
| Percent Of With Depression | 11 |
| Percent Of With Diabetes | 15 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 17 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 30 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8664 |