| National Provider Identifier [NPI]: | 1497800783 |
| Last Name Of The Provider | ERDMANN |
| First Name Of The Provider | KIM |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6951 S MICHIGAN ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | THREE LAKES |
| Zip Code Of The Provider | 545629281 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 52 |
| Number Of Services | 700 |
| Number Of Medicare Beneficiaries | 175 |
| Total Submitted Charge Amount | 86526.5 |
| Total Medicare Allowed Amount | 38130.72 |
| Total Medicare Payment Amount | 25819.26 |
| Total Medicare Standardized Payment Amount | 27082.75 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 46 |
| Number Of Medicare Beneficiaries With Drug Services | 31 |
| Total Drug Submitted ChargeAmount | 767 |
| Total Drug Medicare AllowedAmount | 591.59 |
| Total Drug Medicare PaymentAmount | 573.81 |
| Total Drug Medicare Standardized Payment Amount | 573.81 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 46 |
| Number Of Medical Services | 654 |
| Number Of Medicare Beneficiaries With Medical Services | 175 |
| Total Medical Submitted Charge Amount | 85759.5 |
| Total Medical Medicare Allowed Amount | 37539.13 |
| Total Medical Medicare Payment Amount | 25245.45 |
| Total Medical Medicare Standardized Payment Amount | 26508.94 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 14 |
| Number Of Beneficiaries Age 65 to 74 | 82 |
| Number Of Beneficiaries Age 75 to 84 | 56 |
| Number Of Beneficiaries Age Greater 84 | 23 |
| Number Of Female Beneficiaries | 127 |
| Number Of Male Beneficiaries | 48 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | 152 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 23 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8872 |