| National Provider Identifier [NPI]: | 1497758627 |
| Last Name Of The Provider | DAWES |
| First Name Of The Provider | KENNETH |
| 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 | 8103 CLEARVISTA PKWY |
| Street Address 2 Of The Provider | STE 220 |
| City Of The Provider | INDIANAPOLIS |
| Zip Code Of The Provider | 462564697 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 101 |
| Number Of Services | 11319 |
| Number Of Medicare Beneficiaries | 1831 |
| Total Submitted Charge Amount | 1232223 |
| Total Medicare Allowed Amount | 710774.09 |
| Total Medicare Payment Amount | 513061.3 |
| Total Medicare Standardized Payment Amount | 534488.61 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 1499 |
| Number Of Medicare Beneficiaries With Drug Services | 98 |
| Total Drug Submitted ChargeAmount | 112035 |
| Total Drug Medicare AllowedAmount | 100070.96 |
| Total Drug Medicare PaymentAmount | 78333.59 |
| Total Drug Medicare Standardized Payment Amount | 78333.59 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 96 |
| Number Of Medical Services | 9820 |
| Number Of Medicare Beneficiaries With Medical Services | 1830 |
| Total Medical Submitted Charge Amount | 1120188 |
| Total Medical Medicare Allowed Amount | 610703.13 |
| Total Medical Medicare Payment Amount | 434727.71 |
| Total Medical Medicare Standardized Payment Amount | 456155.02 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 81 |
| Number Of Beneficiaries Age 65 to 74 | 883 |
| Number Of Beneficiaries Age 75 to 84 | 620 |
| Number Of Beneficiaries Age Greater 84 | 247 |
| Number Of Female Beneficiaries | 935 |
| Number Of Male Beneficiaries | 896 |
| Number Of Non Hispanic White Beneficiaries | 1749 |
| Number Of Black or African American Beneficiaries | 39 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 28 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1746 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 85 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 62 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.9777 |