| National Provider Identifier [NPI]: | 1538292321 |
| Last Name Of The Provider | KELSEN |
| First Name Of The Provider | KENNETH |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2287 MOWRY AVE |
| Street Address 2 Of The Provider | STE H |
| City Of The Provider | FREMONT |
| Zip Code Of The Provider | 94538 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Gastroenterology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 27 |
| Number Of Services | 665 |
| Number Of Medicare Beneficiaries | 233 |
| Total Submitted Charge Amount | 95116.87 |
| Total Medicare Allowed Amount | 44173.12 |
| Total Medicare Payment Amount | 31694.56 |
| Total Medicare Standardized Payment Amount | 28288.63 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 28 |
| Number Of Medicare Beneficiaries With Drug Services | 24 |
| Total Drug Submitted ChargeAmount | 850 |
| Total Drug Medicare AllowedAmount | 381.41 |
| Total Drug Medicare PaymentAmount | 373.26 |
| Total Drug Medicare Standardized Payment Amount | 373.26 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 23 |
| Number Of Medical Services | 637 |
| Number Of Medicare Beneficiaries With Medical Services | 233 |
| Total Medical Submitted Charge Amount | 94266.87 |
| Total Medical Medicare Allowed Amount | 43791.71 |
| Total Medical Medicare Payment Amount | 31321.3 |
| Total Medical Medicare Standardized Payment Amount | 27915.37 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 25 |
| Number Of Beneficiaries Age 65 to 74 | 68 |
| Number Of Beneficiaries Age 75 to 84 | 65 |
| Number Of Beneficiaries Age Greater 84 | 75 |
| Number Of Female Beneficiaries | 118 |
| Number Of Male Beneficiaries | 115 |
| Number Of Non Hispanic White Beneficiaries | 134 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 51 |
| Number Of Hispanic Beneficiaries | 33 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 158 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 75 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 28 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 39 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 49 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 53 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 16 |
| Average HCC Risk Score Of Beneficiaries | 2.083 |