| National Provider Identifier [NPI]: | 1932150729 |
| Last Name Of The Provider | KINNEBREW |
| First Name Of The Provider | TODD |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 301 MARGIE DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | WARNER ROBINS |
| Zip Code Of The Provider | 310887818 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 146 |
| Number Of Services | 10470 |
| Number Of Medicare Beneficiaries | 942 |
| Total Submitted Charge Amount | 2189804.53 |
| Total Medicare Allowed Amount | 499742.77 |
| Total Medicare Payment Amount | 367962.39 |
| Total Medicare Standardized Payment Amount | 377235.41 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 3814 |
| Number Of Medicare Beneficiaries With Drug Services | 363 |
| Total Drug Submitted ChargeAmount | 103185 |
| Total Drug Medicare AllowedAmount | 43059.35 |
| Total Drug Medicare PaymentAmount | 30553.41 |
| Total Drug Medicare Standardized Payment Amount | 30553.41 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 142 |
| Number Of Medical Services | 6656 |
| Number Of Medicare Beneficiaries With Medical Services | 942 |
| Total Medical Submitted Charge Amount | 2086619.53 |
| Total Medical Medicare Allowed Amount | 456683.42 |
| Total Medical Medicare Payment Amount | 337408.98 |
| Total Medical Medicare Standardized Payment Amount | 346682 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 146 |
| Number Of Beneficiaries Age 65 to 74 | 475 |
| Number Of Beneficiaries Age 75 to 84 | 266 |
| Number Of Beneficiaries Age Greater 84 | 55 |
| Number Of Female Beneficiaries | 606 |
| Number Of Male Beneficiaries | 336 |
| Number Of Non Hispanic White Beneficiaries | 770 |
| Number Of Black or African American Beneficiaries | 147 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 12 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 838 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 104 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 73 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 8 |
| 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 | 1.1622 |