National Provider Identifier [NPI]: |
1609813823 |
Last Name Of The Provider |
KIM |
First Name Of The Provider |
JOSEPH |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
13700 ST FRANCIS BLVD |
Street Address 2 Of The Provider |
SUITE 103 |
City Of The Provider |
MIDLOTHIAN |
Zip Code Of The Provider |
231143222 |
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 |
47 |
Number Of Services |
3977 |
Number Of Medicare Beneficiaries |
786 |
Total Submitted Charge Amount |
1552216.99 |
Total Medicare Allowed Amount |
456912.21 |
Total Medicare Payment Amount |
347172.89 |
Total Medicare Standardized Payment Amount |
342527.85 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
1578 |
Number Of Medicare Beneficiaries With Drug Services |
134 |
Total Drug Submitted ChargeAmount |
4758 |
Total Drug Medicare AllowedAmount |
2831.41 |
Total Drug Medicare PaymentAmount |
2151.73 |
Total Drug Medicare Standardized Payment Amount |
2151.73 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
45 |
Number Of Medical Services |
2399 |
Number Of Medicare Beneficiaries With Medical Services |
786 |
Total Medical Submitted Charge Amount |
1547458.99 |
Total Medical Medicare Allowed Amount |
454080.8 |
Total Medical Medicare Payment Amount |
345021.16 |
Total Medical Medicare Standardized Payment Amount |
340376.12 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
109 |
Number Of Beneficiaries Age 65 to 74 |
408 |
Number Of Beneficiaries Age 75 to 84 |
208 |
Number Of Beneficiaries Age Greater 84 |
61 |
Number Of Female Beneficiaries |
480 |
Number Of Male Beneficiaries |
306 |
Number Of Non Hispanic White Beneficiaries |
630 |
Number Of Black or African American Beneficiaries |
126 |
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 |
12 |
Number Of Beneficiaries With Medicare Only Entitlement |
706 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
80 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
67 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.038 |