| National Provider Identifier [NPI]: | 1366547317 |
| Last Name Of The Provider | KENNEDY |
| First Name Of The Provider | COLLEEN |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6401 EL VERDE RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | SAN ANTONIO |
| Zip Code Of The Provider | 782382323 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Geriatric Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 20 |
| Number Of Services | 830 |
| Number Of Medicare Beneficiaries | 200 |
| Total Submitted Charge Amount | 115675 |
| Total Medicare Allowed Amount | 88469.27 |
| Total Medicare Payment Amount | 63713.82 |
| Total Medicare Standardized Payment Amount | 68514.34 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 37 |
| Number Of Medicare Beneficiaries With Drug Services | 36 |
| Total Drug Submitted ChargeAmount | 1455 |
| Total Drug Medicare AllowedAmount | 318.74 |
| Total Drug Medicare PaymentAmount | 311.73 |
| Total Drug Medicare Standardized Payment Amount | 311.73 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 17 |
| Number Of Medical Services | 793 |
| Number Of Medicare Beneficiaries With Medical Services | 200 |
| Total Medical Submitted Charge Amount | 114220 |
| Total Medical Medicare Allowed Amount | 88150.53 |
| Total Medical Medicare Payment Amount | 63402.09 |
| Total Medical Medicare Standardized Payment Amount | 68202.61 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 74 |
| Number Of Beneficiaries Age 75 to 84 | 76 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 136 |
| Number Of Male Beneficiaries | 64 |
| Number Of Non Hispanic White Beneficiaries | 156 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 32 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| 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 | 15 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 62 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.3191 |