National Provider Identifier [NPI]: |
1023059193 |
Last Name Of The Provider |
KENDRICK |
First Name Of The Provider |
GREGORY |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
437 DENISON ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
CONWAY |
Zip Code Of The Provider |
720346127 |
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 |
26 |
Number Of Services |
4021 |
Number Of Medicare Beneficiaries |
1100 |
Total Submitted Charge Amount |
841609 |
Total Medicare Allowed Amount |
420520.89 |
Total Medicare Payment Amount |
325625.27 |
Total Medicare Standardized Payment Amount |
289767.74 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
26 |
Number Of Medical Services |
4021 |
Number Of Medicare Beneficiaries With Medical Services |
1100 |
Total Medical Submitted Charge Amount |
841609 |
Total Medical Medicare Allowed Amount |
420520.89 |
Total Medical Medicare Payment Amount |
325625.27 |
Total Medical Medicare Standardized Payment Amount |
289767.74 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
193 |
Number Of Beneficiaries Age 65 to 74 |
289 |
Number Of Beneficiaries Age 75 to 84 |
342 |
Number Of Beneficiaries Age Greater 84 |
276 |
Number Of Female Beneficiaries |
659 |
Number Of Male Beneficiaries |
441 |
Number Of Non Hispanic White Beneficiaries |
1001 |
Number Of Black or African American Beneficiaries |
83 |
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 |
693 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
407 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
41 |
Percent Of With Asthma |
23 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
46 |
Percent Of With Chronic Kidney Disease |
50 |
Percent Of With Chronic Obstructive Pulmonary Disease |
38 |
Percent Of With Depression |
44 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
54 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
14 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
1.9753 |