| National Provider Identifier [NPI]: | 1962497974 |
| Last Name Of The Provider | KOCH |
| First Name Of The Provider | ROBERT |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 35 TOWER CT |
| Street Address 2 Of The Provider | STE F |
| City Of The Provider | GURNEE |
| Zip Code Of The Provider | 600315712 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 81 |
| Number Of Services | 8336 |
| Number Of Medicare Beneficiaries | 2203 |
| Total Submitted Charge Amount | 1565870 |
| Total Medicare Allowed Amount | 818394.93 |
| Total Medicare Payment Amount | 621740.39 |
| Total Medicare Standardized Payment Amount | 592690.62 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 566 |
| Number Of Medicare Beneficiaries With Drug Services | 132 |
| Total Drug Submitted ChargeAmount | 56600 |
| Total Drug Medicare AllowedAmount | 29241.05 |
| Total Drug Medicare PaymentAmount | 22924.87 |
| Total Drug Medicare Standardized Payment Amount | 22924.87 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 78 |
| Number Of Medical Services | 7770 |
| Number Of Medicare Beneficiaries With Medical Services | 2203 |
| Total Medical Submitted Charge Amount | 1509270 |
| Total Medical Medicare Allowed Amount | 789153.88 |
| Total Medical Medicare Payment Amount | 598815.52 |
| Total Medical Medicare Standardized Payment Amount | 569765.75 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 240 |
| Number Of Beneficiaries Age 65 to 74 | 749 |
| Number Of Beneficiaries Age 75 to 84 | 720 |
| Number Of Beneficiaries Age Greater 84 | 494 |
| Number Of Female Beneficiaries | 1171 |
| Number Of Male Beneficiaries | 1032 |
| Number Of Non Hispanic White Beneficiaries | 1826 |
| Number Of Black or African American Beneficiaries | 172 |
| Number Of AsianPacific Islander Beneficiaries | 38 |
| Number Of Hispanic Beneficiaries | 138 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1767 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 436 |
| Percent Of With Atrial Fibrillation | 31 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 50 |
| Percent Of With Chronic Kidney Disease | 44 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 33 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 72 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 70 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 1.9103 |