National Provider Identifier [NPI]: |
1679541122 |
Last Name Of The Provider |
KENDALL |
First Name Of The Provider |
DANIEL |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
DO |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2800 S SHIRLINGTON RD |
Street Address 2 Of The Provider |
SUITE 102 |
City Of The Provider |
ARLINGTON |
Zip Code Of The Provider |
222063601 |
State Code Of The Provider |
VA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Interventional Pain Management |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
70 |
Number Of Services |
14657 |
Number Of Medicare Beneficiaries |
753 |
Total Submitted Charge Amount |
6559186 |
Total Medicare Allowed Amount |
1578174.91 |
Total Medicare Payment Amount |
1211523.47 |
Total Medicare Standardized Payment Amount |
940173.35 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
9 |
Number Of Drug Services |
7741 |
Number Of Medicare Beneficiaries With Drug Services |
628 |
Total Drug Submitted ChargeAmount |
295774 |
Total Drug Medicare AllowedAmount |
21189.33 |
Total Drug Medicare PaymentAmount |
16262.58 |
Total Drug Medicare Standardized Payment Amount |
16262.58 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
61 |
Number Of Medical Services |
6916 |
Number Of Medicare Beneficiaries With Medical Services |
753 |
Total Medical Submitted Charge Amount |
6263412 |
Total Medical Medicare Allowed Amount |
1556985.58 |
Total Medical Medicare Payment Amount |
1195260.89 |
Total Medical Medicare Standardized Payment Amount |
923910.77 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
68 |
Number Of Beneficiaries Age 65 to 74 |
358 |
Number Of Beneficiaries Age 75 to 84 |
237 |
Number Of Beneficiaries Age Greater 84 |
90 |
Number Of Female Beneficiaries |
458 |
Number Of Male Beneficiaries |
295 |
Number Of Non Hispanic White Beneficiaries |
642 |
Number Of Black or African American Beneficiaries |
36 |
Number Of AsianPacific Islander Beneficiaries |
43 |
Number Of Hispanic Beneficiaries |
18 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
700 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
53 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
23 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
62 |
Percent Of With Ischemic Heart Disease |
26 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.0715 |