National Provider Identifier [NPI]: |
1235349390 |
Last Name Of The Provider |
KENDRICK |
First Name Of The Provider |
ANNA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4301 W MARKHAM ST |
Street Address 2 Of The Provider |
SLOT 641 |
City Of The Provider |
LITTLE ROCK |
Zip Code Of The Provider |
722057101 |
State Code Of The Provider |
AR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
28 |
Number Of Services |
245 |
Number Of Medicare Beneficiaries |
88 |
Total Submitted Charge Amount |
35109 |
Total Medicare Allowed Amount |
19407.44 |
Total Medicare Payment Amount |
14857.27 |
Total Medicare Standardized Payment Amount |
16568.86 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
13 |
Number Of Medicare Beneficiaries With Drug Services |
11 |
Total Drug Submitted ChargeAmount |
445 |
Total Drug Medicare AllowedAmount |
252.94 |
Total Drug Medicare PaymentAmount |
247.7 |
Total Drug Medicare Standardized Payment Amount |
247.7 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
24 |
Number Of Medical Services |
232 |
Number Of Medicare Beneficiaries With Medical Services |
88 |
Total Medical Submitted Charge Amount |
34664 |
Total Medical Medicare Allowed Amount |
19154.5 |
Total Medical Medicare Payment Amount |
14609.57 |
Total Medical Medicare Standardized Payment Amount |
16321.16 |
Average Age Of Beneficiaries |
62 |
Number Of Beneficiaries Age Less65 |
40 |
Number Of Beneficiaries Age 65 to 74 |
25 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
65 |
Number Of Male Beneficiaries |
23 |
Number Of Non Hispanic White Beneficiaries |
60 |
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 |
66 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
22 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
32 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
44 |
Percent Of With Hypertension |
67 |
Percent Of With Ischemic Heart Disease |
23 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0028 |