| National Provider Identifier [NPI]: | 1881697548 |
| Last Name Of The Provider | KIENE |
| First Name Of The Provider | KEVIN |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 640 W MOANA LN |
| Street Address 2 Of The Provider | |
| City Of The Provider | RENO |
| Zip Code Of The Provider | 895094857 |
| State Code Of The Provider | NV |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 109 |
| Number Of Services | 4773 |
| Number Of Medicare Beneficiaries | 996 |
| Total Submitted Charge Amount | 1708676.25 |
| Total Medicare Allowed Amount | 1189087.54 |
| Total Medicare Payment Amount | 903570.52 |
| Total Medicare Standardized Payment Amount | 776183.9 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 100 |
| Number Of Medicare Beneficiaries With Drug Services | 31 |
| Total Drug Submitted ChargeAmount | 830.25 |
| Total Drug Medicare AllowedAmount | 815.06 |
| Total Drug Medicare PaymentAmount | 638.96 |
| Total Drug Medicare Standardized Payment Amount | 638.96 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 106 |
| Number Of Medical Services | 4673 |
| Number Of Medicare Beneficiaries With Medical Services | 996 |
| Total Medical Submitted Charge Amount | 1707846 |
| Total Medical Medicare Allowed Amount | 1188272.48 |
| Total Medical Medicare Payment Amount | 902931.56 |
| Total Medical Medicare Standardized Payment Amount | 775544.94 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 50 |
| Number Of Beneficiaries Age 65 to 74 | 441 |
| Number Of Beneficiaries Age 75 to 84 | 344 |
| Number Of Beneficiaries Age Greater 84 | 161 |
| Number Of Female Beneficiaries | 444 |
| Number Of Male Beneficiaries | 552 |
| Number Of Non Hispanic White Beneficiaries | 954 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 22 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 962 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 34 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 3 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 11 |
| Percent Of With Diabetes | 18 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 54 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.9712 |