| National Provider Identifier [NPI]: | 1407821424 |
| Last Name Of The Provider | KENNEDY |
| First Name Of The Provider | STEPHEN |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1200 7TH AVENUE NORTH |
| Street Address 2 Of The Provider | |
| City Of The Provider | ST. PETERSBURG |
| Zip Code Of The Provider | 337051300 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 190 |
| Number Of Services | 18856 |
| Number Of Medicare Beneficiaries | 2738 |
| Total Submitted Charge Amount | 1162385.03 |
| Total Medicare Allowed Amount | 295443.17 |
| Total Medicare Payment Amount | 227282.7 |
| Total Medicare Standardized Payment Amount | 233319.46 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 14912 |
| Number Of Medicare Beneficiaries With Drug Services | 160 |
| Total Drug Submitted ChargeAmount | 40985.04 |
| Total Drug Medicare AllowedAmount | 4588.74 |
| Total Drug Medicare PaymentAmount | 3541.79 |
| Total Drug Medicare Standardized Payment Amount | 3541.79 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 186 |
| Number Of Medical Services | 3944 |
| Number Of Medicare Beneficiaries With Medical Services | 2734 |
| Total Medical Submitted Charge Amount | 1121399.99 |
| Total Medical Medicare Allowed Amount | 290854.43 |
| Total Medical Medicare Payment Amount | 223740.91 |
| Total Medical Medicare Standardized Payment Amount | 229777.67 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 466 |
| Number Of Beneficiaries Age 65 to 74 | 921 |
| Number Of Beneficiaries Age 75 to 84 | 812 |
| Number Of Beneficiaries Age Greater 84 | 539 |
| Number Of Female Beneficiaries | 1679 |
| Number Of Male Beneficiaries | 1059 |
| Number Of Non Hispanic White Beneficiaries | 1768 |
| Number Of Black or African American Beneficiaries | 374 |
| Number Of AsianPacific Islander Beneficiaries | 28 |
| Number Of Hispanic Beneficiaries | 544 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 24 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1773 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 965 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 30 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 35 |
| Percent Of With Chronic Kidney Disease | 43 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 32 |
| Percent Of With Depression | 41 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 61 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 16 |
| Average HCC Risk Score Of Beneficiaries | 2.0949 |