| National Provider Identifier [NPI]: | 1386859775 |
| Last Name Of The Provider | KENDRA |
| First Name Of The Provider | JEREMY |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1000 HARRINGTON ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | MOUNT CLEMENS |
| Zip Code Of The Provider | 480432920 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 178 |
| Number Of Services | 10582 |
| Number Of Medicare Beneficiaries | 2560 |
| Total Submitted Charge Amount | 823988.83 |
| Total Medicare Allowed Amount | 230380.41 |
| Total Medicare Payment Amount | 180513.88 |
| Total Medicare Standardized Payment Amount | 178191.79 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 6035 |
| Number Of Medicare Beneficiaries With Drug Services | 101 |
| Total Drug Submitted ChargeAmount | 10415 |
| Total Drug Medicare AllowedAmount | 3775.21 |
| Total Drug Medicare PaymentAmount | 2959.79 |
| Total Drug Medicare Standardized Payment Amount | 2959.79 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 176 |
| Number Of Medical Services | 4547 |
| Number Of Medicare Beneficiaries With Medical Services | 2560 |
| Total Medical Submitted Charge Amount | 813573.83 |
| Total Medical Medicare Allowed Amount | 226605.2 |
| Total Medical Medicare Payment Amount | 177554.09 |
| Total Medical Medicare Standardized Payment Amount | 175232 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 699 |
| Number Of Beneficiaries Age 65 to 74 | 884 |
| Number Of Beneficiaries Age 75 to 84 | 628 |
| Number Of Beneficiaries Age Greater 84 | 349 |
| Number Of Female Beneficiaries | 1544 |
| Number Of Male Beneficiaries | 1016 |
| Number Of Non Hispanic White Beneficiaries | 2173 |
| Number Of Black or African American Beneficiaries | 303 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 51 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 22 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1766 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 794 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 23 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 37 |
| Percent Of With Chronic Kidney Disease | 43 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 37 |
| Percent Of With Depression | 38 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 58 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 55 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 2.0303 |