| National Provider Identifier [NPI]: | 1902895568 |
| Last Name Of The Provider | SHRUM |
| First Name Of The Provider | KIM |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 18700 W LAKE HOUSTON PKWY |
| Street Address 2 Of The Provider | STE B101 |
| City Of The Provider | HUMBLE |
| Zip Code Of The Provider | 773463349 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 32 |
| Number Of Services | 2999 |
| Number Of Medicare Beneficiaries | 1416 |
| Total Submitted Charge Amount | 1839488 |
| Total Medicare Allowed Amount | 514058.2 |
| Total Medicare Payment Amount | 369950 |
| Total Medicare Standardized Payment Amount | 386582.46 |
| 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 | 32 |
| Number Of Medical Services | 2999 |
| Number Of Medicare Beneficiaries With Medical Services | 1416 |
| Total Medical Submitted Charge Amount | 1839488 |
| Total Medical Medicare Allowed Amount | 514058.2 |
| Total Medical Medicare Payment Amount | 369950 |
| Total Medical Medicare Standardized Payment Amount | 386582.46 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 77 |
| Number Of Beneficiaries Age 65 to 74 | 713 |
| Number Of Beneficiaries Age 75 to 84 | 465 |
| Number Of Beneficiaries Age Greater 84 | 161 |
| Number Of Female Beneficiaries | 877 |
| Number Of Male Beneficiaries | 539 |
| Number Of Non Hispanic White Beneficiaries | 1180 |
| Number Of Black or African American Beneficiaries | 121 |
| Number Of AsianPacific Islander Beneficiaries | 22 |
| Number Of Hispanic Beneficiaries | 81 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 12 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1253 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 163 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.2015 |