National Provider Identifier [NPI]: |
1639356819 |
Last Name Of The Provider |
KENDALL |
First Name Of The Provider |
KEVIN |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
22028 HIGHLAND KNOLLS DR BLDG D |
Street Address 2 Of The Provider |
|
City Of The Provider |
KATY |
Zip Code Of The Provider |
774505859 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
44 |
Number Of Services |
2447 |
Number Of Medicare Beneficiaries |
212 |
Total Submitted Charge Amount |
209089 |
Total Medicare Allowed Amount |
133955.88 |
Total Medicare Payment Amount |
100814.19 |
Total Medicare Standardized Payment Amount |
101949.7 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
13 |
Number Of Drug Services |
625 |
Number Of Medicare Beneficiaries With Drug Services |
102 |
Total Drug Submitted ChargeAmount |
12640 |
Total Drug Medicare AllowedAmount |
1682.18 |
Total Drug Medicare PaymentAmount |
1475.37 |
Total Drug Medicare Standardized Payment Amount |
1475.37 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
31 |
Number Of Medical Services |
1822 |
Number Of Medicare Beneficiaries With Medical Services |
212 |
Total Medical Submitted Charge Amount |
196449 |
Total Medical Medicare Allowed Amount |
132273.7 |
Total Medical Medicare Payment Amount |
99338.82 |
Total Medical Medicare Standardized Payment Amount |
100474.33 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
15 |
Number Of Beneficiaries Age 65 to 74 |
106 |
Number Of Beneficiaries Age 75 to 84 |
59 |
Number Of Beneficiaries Age Greater 84 |
32 |
Number Of Female Beneficiaries |
125 |
Number Of Male Beneficiaries |
87 |
Number Of Non Hispanic White Beneficiaries |
120 |
Number Of Black or African American Beneficiaries |
42 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
33 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
166 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
46 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
20 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
70 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
40 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.2353 |