| National Provider Identifier [NPI]: | 1881699759 |
| Last Name Of The Provider | HAMELBERG |
| First Name Of The Provider | KIM |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | MD. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 495 COOPER RD |
| Street Address 2 Of The Provider | STE 430 |
| City Of The Provider | WESTERVILLE |
| Zip Code Of The Provider | 430818723 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | General Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 61 |
| Number Of Services | 451 |
| Number Of Medicare Beneficiaries | 198 |
| Total Submitted Charge Amount | 309779.01 |
| Total Medicare Allowed Amount | 92336.24 |
| Total Medicare Payment Amount | 71500.7 |
| Total Medicare Standardized Payment Amount | 72461.23 |
| 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 | 61 |
| Number Of Medical Services | 451 |
| Number Of Medicare Beneficiaries With Medical Services | 198 |
| Total Medical Submitted Charge Amount | 309779.01 |
| Total Medical Medicare Allowed Amount | 92336.24 |
| Total Medical Medicare Payment Amount | 71500.7 |
| Total Medical Medicare Standardized Payment Amount | 72461.23 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 36 |
| Number Of Beneficiaries Age 65 to 74 | 88 |
| Number Of Beneficiaries Age 75 to 84 | 38 |
| Number Of Beneficiaries Age Greater 84 | 36 |
| Number Of Female Beneficiaries | 115 |
| Number Of Male Beneficiaries | 83 |
| Number Of Non Hispanic White Beneficiaries | 166 |
| 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 | 145 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 53 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 42 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.7879 |