| National Provider Identifier [NPI]: | 1871588509 |
| Last Name Of The Provider | KERTAY |
| First Name Of The Provider | CHARLES |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 401 BURRO ALY |
| Street Address 2 Of The Provider | |
| City Of The Provider | MORENCI |
| Zip Code Of The Provider | 855409647 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 68 |
| Number Of Services | 558 |
| Number Of Medicare Beneficiaries | 59 |
| Total Submitted Charge Amount | 40402 |
| Total Medicare Allowed Amount | 24161.34 |
| Total Medicare Payment Amount | 18120.84 |
| Total Medicare Standardized Payment Amount | 18219.09 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 14 |
| Number Of Drug Services | 212 |
| Number Of Medicare Beneficiaries With Drug Services | 21 |
| Total Drug Submitted ChargeAmount | 3908 |
| Total Drug Medicare AllowedAmount | 142.49 |
| Total Drug Medicare PaymentAmount | 102.34 |
| Total Drug Medicare Standardized Payment Amount | 102.34 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 54 |
| Number Of Medical Services | 346 |
| Number Of Medicare Beneficiaries With Medical Services | 59 |
| Total Medical Submitted Charge Amount | 36494 |
| Total Medical Medicare Allowed Amount | 24018.85 |
| Total Medical Medicare Payment Amount | 18018.5 |
| Total Medical Medicare Standardized Payment Amount | 18116.75 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 28 |
| Number Of Beneficiaries Age 75 to 84 | 16 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 38 |
| Number Of Male Beneficiaries | 21 |
| Number Of Non Hispanic White Beneficiaries | 30 |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| 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 | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 31 |
| Percent Of With Hypertension | 56 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 22 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.998 |