| National Provider Identifier [NPI]: | 1275504219 |
| Last Name Of The Provider | MITHOEFER |
| First Name Of The Provider | KAI |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 291 INDEPENDENCE DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | CHESTNUT HILL |
| Zip Code Of The Provider | 024673628 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 20 |
| Number Of Services | 794 |
| Number Of Medicare Beneficiaries | 186 |
| Total Submitted Charge Amount | 110260.75 |
| Total Medicare Allowed Amount | 71480.5 |
| Total Medicare Payment Amount | 53720.12 |
| Total Medicare Standardized Payment Amount | 53390.32 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 366 |
| Number Of Medicare Beneficiaries With Drug Services | 49 |
| Total Drug Submitted ChargeAmount | 7119 |
| Total Drug Medicare AllowedAmount | 4209.75 |
| Total Drug Medicare PaymentAmount | 3290.19 |
| Total Drug Medicare Standardized Payment Amount | 3290.19 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 17 |
| Number Of Medical Services | 428 |
| Number Of Medicare Beneficiaries With Medical Services | 186 |
| Total Medical Submitted Charge Amount | 103141.75 |
| Total Medical Medicare Allowed Amount | 67270.75 |
| Total Medical Medicare Payment Amount | 50429.93 |
| Total Medical Medicare Standardized Payment Amount | 50100.13 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 131 |
| Number Of Beneficiaries Age 75 to 84 | 28 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 108 |
| Number Of Male Beneficiaries | 78 |
| Number Of Non Hispanic White Beneficiaries | 147 |
| Number Of Black or African American Beneficiaries | 17 |
| 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 | 168 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 18 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 6 |
| Percent Of With Chronic Kidney Disease | 11 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 14 |
| Percent Of With Hyperlipidemia | 40 |
| Percent Of With Hypertension | 41 |
| Percent Of With Ischemic Heart Disease | 12 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.6564 |