| National Provider Identifier [NPI]: | 1780734202 |
| Last Name Of The Provider | KING |
| First Name Of The Provider | LOREN |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 111 LAUREL CREEK RD SE # A |
| Street Address 2 Of The Provider | |
| City Of The Provider | CALHOUN |
| Zip Code Of The Provider | 307017000 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 87 |
| Number Of Services | 6585 |
| Number Of Medicare Beneficiaries | 382 |
| Total Submitted Charge Amount | 451862.14 |
| Total Medicare Allowed Amount | 212030.35 |
| Total Medicare Payment Amount | 146748.2 |
| Total Medicare Standardized Payment Amount | 167474.97 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 13 |
| Number Of Drug Services | 1570 |
| Number Of Medicare Beneficiaries With Drug Services | 231 |
| Total Drug Submitted ChargeAmount | 46954.2 |
| Total Drug Medicare AllowedAmount | 2219.91 |
| Total Drug Medicare PaymentAmount | 1959.08 |
| Total Drug Medicare Standardized Payment Amount | 1959.08 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 74 |
| Number Of Medical Services | 5015 |
| Number Of Medicare Beneficiaries With Medical Services | 382 |
| Total Medical Submitted Charge Amount | 404907.94 |
| Total Medical Medicare Allowed Amount | 209810.44 |
| Total Medical Medicare Payment Amount | 144789.12 |
| Total Medical Medicare Standardized Payment Amount | 165515.89 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 72 |
| Number Of Beneficiaries Age 65 to 74 | 185 |
| Number Of Beneficiaries Age 75 to 84 | 104 |
| Number Of Beneficiaries Age Greater 84 | 21 |
| Number Of Female Beneficiaries | 213 |
| Number Of Male Beneficiaries | 169 |
| Number Of Non Hispanic White Beneficiaries | 364 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 290 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 92 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0678 |