| National Provider Identifier [NPI]: | 1851388391 |
| Last Name Of The Provider | KOEPKE |
| First Name Of The Provider | KEITH |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7575 NORTHCLIFF AVE |
| Street Address 2 Of The Provider | #400 |
| City Of The Provider | BROOKLYN |
| Zip Code Of The Provider | 441443267 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 58 |
| Number Of Services | 1976 |
| Number Of Medicare Beneficiaries | 218 |
| Total Submitted Charge Amount | 135681 |
| Total Medicare Allowed Amount | 94379.36 |
| Total Medicare Payment Amount | 71610.69 |
| Total Medicare Standardized Payment Amount | 75029.57 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 355 |
| Number Of Medicare Beneficiaries With Drug Services | 86 |
| Total Drug Submitted ChargeAmount | 10746 |
| Total Drug Medicare AllowedAmount | 5536.66 |
| Total Drug Medicare PaymentAmount | 4670.87 |
| Total Drug Medicare Standardized Payment Amount | 4670.87 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 52 |
| Number Of Medical Services | 1621 |
| Number Of Medicare Beneficiaries With Medical Services | 218 |
| Total Medical Submitted Charge Amount | 124935 |
| Total Medical Medicare Allowed Amount | 88842.7 |
| Total Medical Medicare Payment Amount | 66939.82 |
| Total Medical Medicare Standardized Payment Amount | 70358.7 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 12 |
| Number Of Beneficiaries Age 65 to 74 | 83 |
| Number Of Beneficiaries Age 75 to 84 | 84 |
| Number Of Beneficiaries Age Greater 84 | 39 |
| Number Of Female Beneficiaries | 111 |
| Number Of Male Beneficiaries | 107 |
| 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 | 204 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 14 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 11 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 10 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 0.9553 |