| National Provider Identifier [NPI]: | 1689854382 |
| Last Name Of The Provider | WARREN |
| First Name Of The Provider | KENNETH |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | DPM |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2 BERRY CT |
| Street Address 2 Of The Provider | |
| City Of The Provider | KENNEBUNK |
| Zip Code Of The Provider | 040436812 |
| State Code Of The Provider | ME |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 33 |
| Number Of Services | 2177 |
| Number Of Medicare Beneficiaries | 428 |
| Total Submitted Charge Amount | 205609.45 |
| Total Medicare Allowed Amount | 134554.14 |
| Total Medicare Payment Amount | 94758.63 |
| Total Medicare Standardized Payment Amount | 95494.36 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 16 |
| Number Of Medicare Beneficiaries With Drug Services | 11 |
| Total Drug Submitted ChargeAmount | 160.45 |
| Total Drug Medicare AllowedAmount | 4.95 |
| Total Drug Medicare PaymentAmount | 3.91 |
| Total Drug Medicare Standardized Payment Amount | 3.91 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 31 |
| Number Of Medical Services | 2161 |
| Number Of Medicare Beneficiaries With Medical Services | 428 |
| Total Medical Submitted Charge Amount | 205449 |
| Total Medical Medicare Allowed Amount | 134549.19 |
| Total Medical Medicare Payment Amount | 94754.72 |
| Total Medical Medicare Standardized Payment Amount | 95490.45 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 54 |
| Number Of Beneficiaries Age 65 to 74 | 138 |
| Number Of Beneficiaries Age 75 to 84 | 134 |
| Number Of Beneficiaries Age Greater 84 | 102 |
| Number Of Female Beneficiaries | 235 |
| Number Of Male Beneficiaries | 193 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | 327 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 101 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.3738 |