| National Provider Identifier [NPI]: | 1932201092 |
| Last Name Of The Provider | KING |
| First Name Of The Provider | TINNA |
| 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 | 522 N NEW BALLAS RD |
| Street Address 2 Of The Provider | STE. 371 |
| City Of The Provider | CREVE COEUR |
| Zip Code Of The Provider | 631416857 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 19 |
| Number Of Services | 221 |
| Number Of Medicare Beneficiaries | 48 |
| Total Submitted Charge Amount | 30327 |
| Total Medicare Allowed Amount | 11264.33 |
| Total Medicare Payment Amount | 9367.57 |
| Total Medicare Standardized Payment Amount | 9578.28 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 32 |
| Number Of Medicare Beneficiaries With Drug Services | 31 |
| Total Drug Submitted ChargeAmount | 1625 |
| Total Drug Medicare AllowedAmount | 1116.5 |
| Total Drug Medicare PaymentAmount | 1094.23 |
| Total Drug Medicare Standardized Payment Amount | 1094.23 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 17 |
| Number Of Medical Services | 189 |
| Number Of Medicare Beneficiaries With Medical Services | 48 |
| Total Medical Submitted Charge Amount | 28702 |
| Total Medical Medicare Allowed Amount | 10147.83 |
| Total Medical Medicare Payment Amount | 8273.34 |
| Total Medical Medicare Standardized Payment Amount | 8484.05 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 24 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | |
| Number Of Male Beneficiaries | |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| 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 | |
| Number Of Beneficiaries With Medicare Only Entitlement | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | |
| Percent Of With Diabetes | |
| Percent Of With Hyperlipidemia | 27 |
| Percent Of With Hypertension | 46 |
| Percent Of With Ischemic Heart Disease | |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 0 |
| Percent Of With Stroke | 0 |
| Average HCC Risk Score Of Beneficiaries | 0.7973 |