| National Provider Identifier [NPI]: | 1659312585 |
| Last Name Of The Provider | STUBBS |
| 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 | 46 SERGEANT PRENTISS DR |
| Street Address 2 Of The Provider | SUITE 300 |
| City Of The Provider | NATCHEZ |
| Zip Code Of The Provider | 391204725 |
| State Code Of The Provider | MS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 159 |
| Number Of Services | 8953 |
| Number Of Medicare Beneficiaries | 1202 |
| Total Submitted Charge Amount | 689627.5 |
| Total Medicare Allowed Amount | 349832.29 |
| Total Medicare Payment Amount | 247048.67 |
| Total Medicare Standardized Payment Amount | 268164.66 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 22 |
| Number Of Drug Services | 1395 |
| Number Of Medicare Beneficiaries With Drug Services | 572 |
| Total Drug Submitted ChargeAmount | 41258.5 |
| Total Drug Medicare AllowedAmount | 11004.66 |
| Total Drug Medicare PaymentAmount | 9114.41 |
| Total Drug Medicare Standardized Payment Amount | 9114.41 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 137 |
| Number Of Medical Services | 7558 |
| Number Of Medicare Beneficiaries With Medical Services | 1202 |
| Total Medical Submitted Charge Amount | 648369 |
| Total Medical Medicare Allowed Amount | 338827.63 |
| Total Medical Medicare Payment Amount | 237934.26 |
| Total Medical Medicare Standardized Payment Amount | 259050.25 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 119 |
| Number Of Beneficiaries Age 65 to 74 | 533 |
| Number Of Beneficiaries Age 75 to 84 | 383 |
| Number Of Beneficiaries Age Greater 84 | 167 |
| Number Of Female Beneficiaries | 748 |
| Number Of Male Beneficiaries | 454 |
| Number Of Non Hispanic White Beneficiaries | 915 |
| Number Of Black or African American Beneficiaries | |
| 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 | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1041 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 161 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0054 |