National Provider Identifier [NPI]: |
1164484630 |
Last Name Of The Provider |
KANG |
First Name Of The Provider |
OK |
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 |
9463 HOLLY RD |
Street Address 2 Of The Provider |
SUITE 102 |
City Of The Provider |
GRAND BLANC |
Zip Code Of The Provider |
484398351 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
69 |
Number Of Services |
605 |
Number Of Medicare Beneficiaries |
167 |
Total Submitted Charge Amount |
173755 |
Total Medicare Allowed Amount |
88426.52 |
Total Medicare Payment Amount |
68304.46 |
Total Medicare Standardized Payment Amount |
70313.08 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
69 |
Number Of Medical Services |
605 |
Number Of Medicare Beneficiaries With Medical Services |
167 |
Total Medical Submitted Charge Amount |
173755 |
Total Medical Medicare Allowed Amount |
88426.52 |
Total Medical Medicare Payment Amount |
68304.46 |
Total Medical Medicare Standardized Payment Amount |
70313.08 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
42 |
Number Of Beneficiaries Age 65 to 74 |
42 |
Number Of Beneficiaries Age 75 to 84 |
45 |
Number Of Beneficiaries Age Greater 84 |
38 |
Number Of Female Beneficiaries |
99 |
Number Of Male Beneficiaries |
68 |
Number Of Non Hispanic White Beneficiaries |
139 |
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 |
111 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
56 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
38 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
52 |
Percent Of With Chronic Kidney Disease |
52 |
Percent Of With Chronic Obstructive Pulmonary Disease |
35 |
Percent Of With Depression |
51 |
Percent Of With Diabetes |
44 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
61 |
Percent Of With Osteoporosis |
16 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
60 |
Percent Of With Schizophrenia Other PsychoticDisorders |
15 |
Percent Of With Stroke |
19 |
Average HCC Risk Score Of Beneficiaries |
2.1084 |