| National Provider Identifier [NPI]: | 1245221209 |
| Last Name Of The Provider | KOENIG |
| First Name Of The Provider | JAN |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2000 N VILLAGE AVE |
| Street Address 2 Of The Provider | SUITE 306 |
| City Of The Provider | ROCKVILLE CENTRE |
| Zip Code Of The Provider | 115701078 |
| State Code Of The Provider | NY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 45 |
| Number Of Services | 3197 |
| Number Of Medicare Beneficiaries | 782 |
| Total Submitted Charge Amount | 2267195 |
| Total Medicare Allowed Amount | 367484.05 |
| Total Medicare Payment Amount | 276900.92 |
| Total Medicare Standardized Payment Amount | 238040.49 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 303 |
| Number Of Medicare Beneficiaries With Drug Services | 120 |
| Total Drug Submitted ChargeAmount | 37785 |
| Total Drug Medicare AllowedAmount | 14404.94 |
| Total Drug Medicare PaymentAmount | 11110.86 |
| Total Drug Medicare Standardized Payment Amount | 11110.86 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 42 |
| Number Of Medical Services | 2894 |
| Number Of Medicare Beneficiaries With Medical Services | 782 |
| Total Medical Submitted Charge Amount | 2229410 |
| Total Medical Medicare Allowed Amount | 353079.11 |
| Total Medical Medicare Payment Amount | 265790.06 |
| Total Medical Medicare Standardized Payment Amount | 226929.63 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 42 |
| Number Of Beneficiaries Age 65 to 74 | 329 |
| Number Of Beneficiaries Age 75 to 84 | 288 |
| Number Of Beneficiaries Age Greater 84 | 123 |
| Number Of Female Beneficiaries | 535 |
| Number Of Male Beneficiaries | 247 |
| Number Of Non Hispanic White Beneficiaries | 685 |
| Number Of Black or African American Beneficiaries | 54 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 19 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 714 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 68 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 11 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.0916 |