| National Provider Identifier [NPI]: | 1871578252 |
| Last Name Of The Provider | KIM |
| First Name Of The Provider | STANLEY |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 12180 N MOPAC EXPY |
| Street Address 2 Of The Provider | STE A |
| City Of The Provider | AUSTIN |
| Zip Code Of The Provider | 787582909 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Neurosurgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 109 |
| Number Of Services | 3219 |
| Number Of Medicare Beneficiaries | 228 |
| Total Submitted Charge Amount | 1541692.89 |
| Total Medicare Allowed Amount | 443477.54 |
| Total Medicare Payment Amount | 340598.72 |
| Total Medicare Standardized Payment Amount | 310062.67 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 2059 |
| Number Of Medicare Beneficiaries With Drug Services | 27 |
| Total Drug Submitted ChargeAmount | 11925 |
| Total Drug Medicare AllowedAmount | 463.2 |
| Total Drug Medicare PaymentAmount | 344.14 |
| Total Drug Medicare Standardized Payment Amount | 344.14 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 104 |
| Number Of Medical Services | 1160 |
| Number Of Medicare Beneficiaries With Medical Services | 228 |
| Total Medical Submitted Charge Amount | 1529767.89 |
| Total Medical Medicare Allowed Amount | 443014.34 |
| Total Medical Medicare Payment Amount | 340254.58 |
| Total Medical Medicare Standardized Payment Amount | 309718.53 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 29 |
| Number Of Beneficiaries Age 65 to 74 | 109 |
| Number Of Beneficiaries Age 75 to 84 | 67 |
| Number Of Beneficiaries Age Greater 84 | 23 |
| Number Of Female Beneficiaries | 140 |
| Number Of Male Beneficiaries | 88 |
| Number Of Non Hispanic White Beneficiaries | 174 |
| Number Of Black or African American Beneficiaries | 23 |
| 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 | 188 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 40 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 43 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 24 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 28 |
| Average HCC Risk Score Of Beneficiaries | 1.3843 |