| National Provider Identifier [NPI]: | 1861484636 |
| Last Name Of The Provider | KAURICH |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1700 CLINTON ST |
| Street Address 2 Of The Provider | RADIOLOGY DEPARTMENT |
| City Of The Provider | MUSKEGON |
| Zip Code Of The Provider | 494425502 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 172 |
| Number Of Services | 4796 |
| Number Of Medicare Beneficiaries | 3208 |
| Total Submitted Charge Amount | 647885.4 |
| Total Medicare Allowed Amount | 174638.82 |
| Total Medicare Payment Amount | 140732.79 |
| Total Medicare Standardized Payment Amount | 146128.53 |
| 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 | 172 |
| Number Of Medical Services | 4796 |
| Number Of Medicare Beneficiaries With Medical Services | 3208 |
| Total Medical Submitted Charge Amount | 647885.4 |
| Total Medical Medicare Allowed Amount | 174638.82 |
| Total Medical Medicare Payment Amount | 140732.79 |
| Total Medical Medicare Standardized Payment Amount | 146128.53 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 806 |
| Number Of Beneficiaries Age 65 to 74 | 1063 |
| Number Of Beneficiaries Age 75 to 84 | 874 |
| Number Of Beneficiaries Age Greater 84 | 465 |
| Number Of Female Beneficiaries | 2037 |
| Number Of Male Beneficiaries | 1171 |
| Number Of Non Hispanic White Beneficiaries | 2663 |
| Number Of Black or African American Beneficiaries | 419 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 79 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 21 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2206 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1002 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.5308 |