| National Provider Identifier [NPI]: | 1629002175 |
| Last Name Of The Provider | KOCH |
| First Name Of The Provider | KAREN |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | P.A.C. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5671 N SKEEL AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | OSCODA |
| Zip Code Of The Provider | 487501535 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 23 |
| Number Of Services | 214 |
| Number Of Medicare Beneficiaries | 73 |
| Total Submitted Charge Amount | 3064 |
| Total Medicare Allowed Amount | 2205.17 |
| Total Medicare Payment Amount | 1211.47 |
| Total Medicare Standardized Payment Amount | 1507.39 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 36 |
| Number Of Medicare Beneficiaries With Drug Services | 14 |
| Total Drug Submitted ChargeAmount | 104 |
| Total Drug Medicare AllowedAmount | 93.3 |
| Total Drug Medicare PaymentAmount | 46.08 |
| Total Drug Medicare Standardized Payment Amount | 46.08 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 21 |
| Number Of Medical Services | 178 |
| Number Of Medicare Beneficiaries With Medical Services | 73 |
| Total Medical Submitted Charge Amount | 2960 |
| Total Medical Medicare Allowed Amount | 2111.87 |
| Total Medical Medicare Payment Amount | 1165.39 |
| Total Medical Medicare Standardized Payment Amount | 1461.31 |
| Average Age Of Beneficiaries | 64 |
| Number Of Beneficiaries Age Less65 | 28 |
| Number Of Beneficiaries Age 65 to 74 | 24 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 54 |
| Number Of Male Beneficiaries | 19 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| 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 | 44 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 29 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.2092 |