| National Provider Identifier [NPI]: | 1306885553 |
| Last Name Of The Provider | KING |
| First Name Of The Provider | ROBERT |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 17321 STATE ROAD 23 |
| Street Address 2 Of The Provider | |
| City Of The Provider | SOUTH BEND |
| Zip Code Of The Provider | 466351531 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 54 |
| Number Of Services | 1019 |
| Number Of Medicare Beneficiaries | 423 |
| Total Submitted Charge Amount | 105321 |
| Total Medicare Allowed Amount | 64398.36 |
| Total Medicare Payment Amount | 46503.85 |
| Total Medicare Standardized Payment Amount | 49152.29 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 56 |
| Number Of Medicare Beneficiaries With Drug Services | 37 |
| Total Drug Submitted ChargeAmount | 1489 |
| Total Drug Medicare AllowedAmount | 1030.76 |
| Total Drug Medicare PaymentAmount | 1003.61 |
| Total Drug Medicare Standardized Payment Amount | 1003.61 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 43 |
| Number Of Medical Services | 963 |
| Number Of Medicare Beneficiaries With Medical Services | 423 |
| Total Medical Submitted Charge Amount | 103832 |
| Total Medical Medicare Allowed Amount | 63367.6 |
| Total Medical Medicare Payment Amount | 45500.24 |
| Total Medical Medicare Standardized Payment Amount | 48148.68 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 150 |
| Number Of Beneficiaries Age 65 to 74 | 110 |
| Number Of Beneficiaries Age 75 to 84 | 96 |
| Number Of Beneficiaries Age Greater 84 | 67 |
| Number Of Female Beneficiaries | 270 |
| Number Of Male Beneficiaries | 153 |
| Number Of Non Hispanic White Beneficiaries | 294 |
| Number Of Black or African American Beneficiaries | 105 |
| 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 | 213 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 210 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 31 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.5097 |