| National Provider Identifier [NPI]: | 1649298134 |
| Last Name Of The Provider | KENNEDY |
| First Name Of The Provider | KEVIN |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1818 SO UNION AVE |
| Street Address 2 Of The Provider | #2-C |
| City Of The Provider | TACOMA |
| Zip Code Of The Provider | 984051953 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Otolaryngology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 38 |
| Number Of Services | 2192 |
| Number Of Medicare Beneficiaries | 800 |
| Total Submitted Charge Amount | 708012 |
| Total Medicare Allowed Amount | 256521.3 |
| Total Medicare Payment Amount | 179250.63 |
| Total Medicare Standardized Payment Amount | 181770.84 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 38 |
| Number Of Medical Services | 2192 |
| Number Of Medicare Beneficiaries With Medical Services | 800 |
| Total Medical Submitted Charge Amount | 708012 |
| Total Medical Medicare Allowed Amount | 256521.3 |
| Total Medical Medicare Payment Amount | 179250.63 |
| Total Medical Medicare Standardized Payment Amount | 181770.84 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 34 |
| Number Of Beneficiaries Age 65 to 74 | 344 |
| Number Of Beneficiaries Age 75 to 84 | 289 |
| Number Of Beneficiaries Age Greater 84 | 133 |
| Number Of Female Beneficiaries | 432 |
| Number Of Male Beneficiaries | 368 |
| Number Of Non Hispanic White Beneficiaries | 672 |
| Number Of Black or African American Beneficiaries | 30 |
| Number Of AsianPacific Islander Beneficiaries | 61 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 17 |
| Number Of Beneficiaries With Medicare Only Entitlement | 710 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 90 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.1439 |