| National Provider Identifier [NPI]: | 1376538041 |
| Last Name Of The Provider | KOCH |
| First Name Of The Provider | KEVIN |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1221 PLEASANT ST |
| Street Address 2 Of The Provider | STE 150 |
| City Of The Provider | DES MOINES |
| Zip Code Of The Provider | 503091423 |
| State Code Of The Provider | IA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 98 |
| Number Of Services | 43458 |
| Number Of Medicare Beneficiaries | 1570 |
| Total Submitted Charge Amount | 1345438 |
| Total Medicare Allowed Amount | 319926.86 |
| Total Medicare Payment Amount | 239987.85 |
| Total Medicare Standardized Payment Amount | 269478.03 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 41220 |
| Number Of Medicare Beneficiaries With Drug Services | 441 |
| Total Drug Submitted ChargeAmount | 60628 |
| Total Drug Medicare AllowedAmount | 10747.39 |
| Total Drug Medicare PaymentAmount | 8273.3 |
| Total Drug Medicare Standardized Payment Amount | 8273.3 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 96 |
| Number Of Medical Services | 2238 |
| Number Of Medicare Beneficiaries With Medical Services | 1570 |
| Total Medical Submitted Charge Amount | 1284810 |
| Total Medical Medicare Allowed Amount | 309179.47 |
| Total Medical Medicare Payment Amount | 231714.55 |
| Total Medical Medicare Standardized Payment Amount | 261204.73 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 193 |
| Number Of Beneficiaries Age 65 to 74 | 747 |
| Number Of Beneficiaries Age 75 to 84 | 466 |
| Number Of Beneficiaries Age Greater 84 | 164 |
| Number Of Female Beneficiaries | 866 |
| Number Of Male Beneficiaries | 704 |
| Number Of Non Hispanic White Beneficiaries | 1503 |
| Number Of Black or African American Beneficiaries | 30 |
| 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 | 17 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1386 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 184 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0696 |