| National Provider Identifier [NPI]: | 1912098534 |
| Last Name Of The Provider | KENNEDY |
| First Name Of The Provider | EDWARD |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 901 PACIFIC STREET |
| Street Address 2 Of The Provider | |
| City Of The Provider | MONTEREY |
| Zip Code Of The Provider | 93940 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 30 |
| Number Of Services | 1844 |
| Number Of Medicare Beneficiaries | 321 |
| Total Submitted Charge Amount | 227062 |
| Total Medicare Allowed Amount | 141653.46 |
| Total Medicare Payment Amount | 107552.01 |
| Total Medicare Standardized Payment Amount | 105634 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 252 |
| Number Of Medicare Beneficiaries With Drug Services | 91 |
| Total Drug Submitted ChargeAmount | 13132 |
| Total Drug Medicare AllowedAmount | 6993.16 |
| Total Drug Medicare PaymentAmount | 6758.52 |
| Total Drug Medicare Standardized Payment Amount | 6758.52 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 23 |
| Number Of Medical Services | 1592 |
| Number Of Medicare Beneficiaries With Medical Services | 321 |
| Total Medical Submitted Charge Amount | 213930 |
| Total Medical Medicare Allowed Amount | 134660.3 |
| Total Medical Medicare Payment Amount | 100793.49 |
| Total Medical Medicare Standardized Payment Amount | 98875.48 |
| Average Age Of Beneficiaries | 79 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 102 |
| Number Of Beneficiaries Age 75 to 84 | 119 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 179 |
| Number Of Male Beneficiaries | 142 |
| Number Of Non Hispanic White Beneficiaries | 293 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| 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 | 13 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 21 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 61 |
| Percent Of With Ischemic Heart Disease | 28 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0056 |