National Provider Identifier [NPI]: |
1891736484 |
Last Name Of The Provider |
KIM |
First Name Of The Provider |
CHRISTOPHER |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1115 BOULDERS PKWY |
Street Address 2 Of The Provider |
SUITE 100 |
City Of The Provider |
NORTH CHESTERFIELD |
Zip Code Of The Provider |
232254067 |
State Code Of The Provider |
VA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Orthopedic Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
112 |
Number Of Services |
552 |
Number Of Medicare Beneficiaries |
182 |
Total Submitted Charge Amount |
275855 |
Total Medicare Allowed Amount |
93909.41 |
Total Medicare Payment Amount |
72566.92 |
Total Medicare Standardized Payment Amount |
73716.83 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
40 |
Number Of Beneficiaries Age 65 to 74 |
67 |
Number Of Beneficiaries Age 75 to 84 |
39 |
Number Of Beneficiaries Age Greater 84 |
36 |
Number Of Female Beneficiaries |
124 |
Number Of Male Beneficiaries |
58 |
Number Of Non Hispanic White Beneficiaries |
140 |
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 |
139 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
43 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
23 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
20 |
Percent Of With Chronic Kidney Disease |
36 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
52 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.7716 |