| National Provider Identifier [NPI]: | 1013900190 |
| Last Name Of The Provider | KERSHEN |
| First Name Of The Provider | GLENN |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1117 S WASHINGTON AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | SAGINAW |
| Zip Code Of The Provider | 486012558 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 95 |
| Number Of Services | 23652 |
| Number Of Medicare Beneficiaries | 2692 |
| Total Submitted Charge Amount | 1285135.75 |
| Total Medicare Allowed Amount | 1139664.53 |
| Total Medicare Payment Amount | 854359.33 |
| Total Medicare Standardized Payment Amount | 883121.62 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 11997 |
| Number Of Medicare Beneficiaries With Drug Services | 104 |
| Total Drug Submitted ChargeAmount | 351454 |
| Total Drug Medicare AllowedAmount | 336748.19 |
| Total Drug Medicare PaymentAmount | 261152.18 |
| Total Drug Medicare Standardized Payment Amount | 261152.18 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 90 |
| Number Of Medical Services | 11655 |
| Number Of Medicare Beneficiaries With Medical Services | 2692 |
| Total Medical Submitted Charge Amount | 933681.75 |
| Total Medical Medicare Allowed Amount | 802916.34 |
| Total Medical Medicare Payment Amount | 593207.15 |
| Total Medical Medicare Standardized Payment Amount | 621969.44 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 360 |
| Number Of Beneficiaries Age 65 to 74 | 1082 |
| Number Of Beneficiaries Age 75 to 84 | 906 |
| Number Of Beneficiaries Age Greater 84 | 344 |
| Number Of Female Beneficiaries | 862 |
| Number Of Male Beneficiaries | 1830 |
| Number Of Non Hispanic White Beneficiaries | 2580 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 47 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 29 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2260 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 432 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 58 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.3388 |