| National Provider Identifier [NPI]: | 1306867742 |
| Last Name Of The Provider | PLUMMER |
| First Name Of The Provider | KENRITH |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | PA |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1493 CAMBRIDGE ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | CAMBRIDGE |
| Zip Code Of The Provider | 021391047 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 60 |
| Number Of Services | 494 |
| Number Of Medicare Beneficiaries | 209 |
| Total Submitted Charge Amount | 39370 |
| Total Medicare Allowed Amount | 26298.99 |
| Total Medicare Payment Amount | 19317.85 |
| Total Medicare Standardized Payment Amount | 21183.02 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 74 |
| Number Of Medicare Beneficiaries With Drug Services | 21 |
| Total Drug Submitted ChargeAmount | 1343 |
| Total Drug Medicare AllowedAmount | 439.09 |
| Total Drug Medicare PaymentAmount | 416.04 |
| Total Drug Medicare Standardized Payment Amount | 416.04 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 52 |
| Number Of Medical Services | 420 |
| Number Of Medicare Beneficiaries With Medical Services | 209 |
| Total Medical Submitted Charge Amount | 38027 |
| Total Medical Medicare Allowed Amount | 25859.9 |
| Total Medical Medicare Payment Amount | 18901.81 |
| Total Medical Medicare Standardized Payment Amount | 20766.98 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 50 |
| Number Of Beneficiaries Age 65 to 74 | 89 |
| Number Of Beneficiaries Age 75 to 84 | 44 |
| Number Of Beneficiaries Age Greater 84 | 26 |
| Number Of Female Beneficiaries | 119 |
| Number Of Male Beneficiaries | 90 |
| Number Of Non Hispanic White Beneficiaries | 188 |
| 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 | |
| Number Of Beneficiaries With Medicare Only Entitlement | 147 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 62 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 38 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 57 |
| Percent Of With Ischemic Heart Disease | 24 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 29 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1826 |