| National Provider Identifier [NPI]: | 1659703734 |
| Last Name Of The Provider | KENNEDY |
| First Name Of The Provider | GLORIA |
| Middle Initial Of The Provider | F |
| Credentials Of The Provider | FNP-BC |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 110 W MAIN ST |
| Street Address 2 Of The Provider | SUITE 2 |
| City Of The Provider | LEBANON |
| Zip Code Of The Provider | 242664214 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 76 |
| Number Of Services | 1417 |
| Number Of Medicare Beneficiaries | 362 |
| Total Submitted Charge Amount | 80731.75 |
| Total Medicare Allowed Amount | 41614.4 |
| Total Medicare Payment Amount | 33462.62 |
| Total Medicare Standardized Payment Amount | 37424.9 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 250 |
| Number Of Medicare Beneficiaries With Drug Services | 36 |
| Total Drug Submitted ChargeAmount | 2968.75 |
| Total Drug Medicare AllowedAmount | 229.15 |
| Total Drug Medicare PaymentAmount | 176.68 |
| Total Drug Medicare Standardized Payment Amount | 176.68 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 70 |
| Number Of Medical Services | 1167 |
| Number Of Medicare Beneficiaries With Medical Services | 362 |
| Total Medical Submitted Charge Amount | 77763 |
| Total Medical Medicare Allowed Amount | 41385.25 |
| Total Medical Medicare Payment Amount | 33285.94 |
| Total Medical Medicare Standardized Payment Amount | 37248.22 |
| Average Age Of Beneficiaries | 63 |
| Number Of Beneficiaries Age Less65 | 190 |
| Number Of Beneficiaries Age 65 to 74 | 93 |
| Number Of Beneficiaries Age 75 to 84 | 64 |
| Number Of Beneficiaries Age Greater 84 | 15 |
| Number Of Female Beneficiaries | 191 |
| Number Of Male Beneficiaries | 171 |
| Number Of Non Hispanic White Beneficiaries | 351 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 0 |
| Number Of Beneficiaries With Medicare Only Entitlement | 161 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 201 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 49 |
| Percent Of With Depression | 58 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 72 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 56 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 15 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.3453 |