| National Provider Identifier [NPI]: | 1447275748 |
| Last Name Of The Provider | KOCH |
| First Name Of The Provider | JACK |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | DPM |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 425 W BONITA AVE STE 110 |
| Street Address 2 Of The Provider | |
| City Of The Provider | SAN DIMAS |
| Zip Code Of The Provider | 917732543 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 11 |
| Number Of Services | 17610 |
| Number Of Medicare Beneficiaries | 3578 |
| Total Submitted Charge Amount | 660786 |
| Total Medicare Allowed Amount | 546963.06 |
| Total Medicare Payment Amount | 405300.88 |
| Total Medicare Standardized Payment Amount | 383965.47 |
| 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 | 11 |
| Number Of Medical Services | 17610 |
| Number Of Medicare Beneficiaries With Medical Services | 3578 |
| Total Medical Submitted Charge Amount | 660786 |
| Total Medical Medicare Allowed Amount | 546963.06 |
| Total Medical Medicare Payment Amount | 405300.88 |
| Total Medical Medicare Standardized Payment Amount | 383965.47 |
| Average Age Of Beneficiaries | 81 |
| Number Of Beneficiaries Age Less65 | 257 |
| Number Of Beneficiaries Age 65 to 74 | 626 |
| Number Of Beneficiaries Age 75 to 84 | 1066 |
| Number Of Beneficiaries Age Greater 84 | 1629 |
| Number Of Female Beneficiaries | 2319 |
| Number Of Male Beneficiaries | 1259 |
| Number Of Non Hispanic White Beneficiaries | 3161 |
| Number Of Black or African American Beneficiaries | 52 |
| Number Of AsianPacific Islander Beneficiaries | 38 |
| Number Of Hispanic Beneficiaries | 207 |
| Number Of American Indian Alaska Native Beneficiaries | 97 |
| Number Of Beneficiaries With Race Not Else where Classified | 23 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1048 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 2530 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 65 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 42 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 33 |
| Percent Of With Depression | 43 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 44 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 17 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 2.0802 |