| National Provider Identifier [NPI]: | 1386637692 |
| Last Name Of The Provider | MILLS |
| First Name Of The Provider | KIM |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2620 HORIZON DR SE |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | GRAND RAPIDS |
| Zip Code Of The Provider | 495467520 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pathology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 35 |
| Number Of Services | 5976 |
| Number Of Medicare Beneficiaries | 2673 |
| Total Submitted Charge Amount | 541751.88 |
| Total Medicare Allowed Amount | 249296.77 |
| Total Medicare Payment Amount | 209567.45 |
| Total Medicare Standardized Payment Amount | 189563.64 |
| 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 | 35 |
| Number Of Medical Services | 5976 |
| Number Of Medicare Beneficiaries With Medical Services | 2673 |
| Total Medical Submitted Charge Amount | 541751.88 |
| Total Medical Medicare Allowed Amount | 249296.77 |
| Total Medical Medicare Payment Amount | 209567.45 |
| Total Medical Medicare Standardized Payment Amount | 189563.64 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 649 |
| Number Of Beneficiaries Age 65 to 74 | 1314 |
| Number Of Beneficiaries Age 75 to 84 | 588 |
| Number Of Beneficiaries Age Greater 84 | 122 |
| Number Of Female Beneficiaries | 2109 |
| Number Of Male Beneficiaries | 564 |
| Number Of Non Hispanic White Beneficiaries | 2378 |
| Number Of Black or African American Beneficiaries | 188 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 57 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 33 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2152 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 521 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 4 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 8 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 56 |
| Percent Of With Ischemic Heart Disease | 24 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.9238 |