| National Provider Identifier [NPI]: | 1801004585 |
| Last Name Of The Provider | KENNEDY |
| First Name Of The Provider | DANIEL |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1320 W MAIN ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | NEWARK |
| Zip Code Of The Provider | 430551822 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 140 |
| Number Of Services | 5461 |
| Number Of Medicare Beneficiaries | 3568 |
| Total Submitted Charge Amount | 518848 |
| Total Medicare Allowed Amount | 149333.43 |
| Total Medicare Payment Amount | 117817.35 |
| Total Medicare Standardized Payment Amount | 121027.44 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 140 |
| Number Of Medical Services | 5461 |
| Number Of Medicare Beneficiaries With Medical Services | 3568 |
| Total Medical Submitted Charge Amount | 518848 |
| Total Medical Medicare Allowed Amount | 149333.43 |
| Total Medical Medicare Payment Amount | 117817.35 |
| Total Medical Medicare Standardized Payment Amount | 121027.44 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 788 |
| Number Of Beneficiaries Age 65 to 74 | 1202 |
| Number Of Beneficiaries Age 75 to 84 | 1030 |
| Number Of Beneficiaries Age Greater 84 | 548 |
| Number Of Female Beneficiaries | 2341 |
| Number Of Male Beneficiaries | 1227 |
| Number Of Non Hispanic White Beneficiaries | 3267 |
| Number Of Black or African American Beneficiaries | 221 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 29 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 33 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2428 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1140 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 34 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 36 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 50 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.7378 |