| National Provider Identifier [NPI]: | 1154404200 |
| Last Name Of The Provider | HORACEK |
| First Name Of The Provider | KENTON |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2020 SANTA MONICA BLVD STE 400 |
| Street Address 2 Of The Provider | |
| City Of The Provider | SANTA MONICA |
| Zip Code Of The Provider | 904042139 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 59 |
| Number Of Services | 2913 |
| Number Of Medicare Beneficiaries | 659 |
| Total Submitted Charge Amount | 868862.71 |
| Total Medicare Allowed Amount | 226351.79 |
| Total Medicare Payment Amount | 172536.4 |
| Total Medicare Standardized Payment Amount | 164888.05 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 509 |
| Number Of Medicare Beneficiaries With Drug Services | 53 |
| Total Drug Submitted ChargeAmount | 33592 |
| Total Drug Medicare AllowedAmount | 14628.67 |
| Total Drug Medicare PaymentAmount | 11468.7 |
| Total Drug Medicare Standardized Payment Amount | 11468.7 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 55 |
| Number Of Medical Services | 2404 |
| Number Of Medicare Beneficiaries With Medical Services | 659 |
| Total Medical Submitted Charge Amount | 835270.71 |
| Total Medical Medicare Allowed Amount | 211723.12 |
| Total Medical Medicare Payment Amount | 161067.7 |
| Total Medical Medicare Standardized Payment Amount | 153419.35 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 18 |
| Number Of Beneficiaries Age 65 to 74 | 255 |
| Number Of Beneficiaries Age 75 to 84 | 260 |
| Number Of Beneficiaries Age Greater 84 | 126 |
| Number Of Female Beneficiaries | 459 |
| Number Of Male Beneficiaries | 200 |
| Number Of Non Hispanic White Beneficiaries | 567 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 27 |
| Number Of Hispanic Beneficiaries | 30 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 18 |
| Number Of Beneficiaries With Medicare Only Entitlement | 564 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 95 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 62 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.1001 |