| National Provider Identifier [NPI]: | 1740398676 |
| Last Name Of The Provider | KIENLE |
| First Name Of The Provider | JANE |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7111 1ST AVE S |
| Street Address 2 Of The Provider | |
| City Of The Provider | ST PETERSBURG |
| Zip Code Of The Provider | 337071223 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Geriatric Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 42 |
| Number Of Services | 2773 |
| Number Of Medicare Beneficiaries | 348 |
| Total Submitted Charge Amount | 195942.97 |
| Total Medicare Allowed Amount | 164382.15 |
| Total Medicare Payment Amount | 116675.47 |
| Total Medicare Standardized Payment Amount | 117766.97 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 30 |
| Number Of Medicare Beneficiaries With Drug Services | 20 |
| Total Drug Submitted ChargeAmount | 447 |
| Total Drug Medicare AllowedAmount | 87.17 |
| Total Drug Medicare PaymentAmount | 61.88 |
| Total Drug Medicare Standardized Payment Amount | 61.88 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 40 |
| Number Of Medical Services | 2743 |
| Number Of Medicare Beneficiaries With Medical Services | 348 |
| Total Medical Submitted Charge Amount | 195495.97 |
| Total Medical Medicare Allowed Amount | 164294.98 |
| Total Medical Medicare Payment Amount | 116613.59 |
| Total Medical Medicare Standardized Payment Amount | 117705.09 |
| Average Age Of Beneficiaries | 81 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | |
| Number Of Beneficiaries Age 75 to 84 | 129 |
| Number Of Beneficiaries Age Greater 84 | 131 |
| Number Of Female Beneficiaries | 246 |
| Number Of Male Beneficiaries | 102 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 8 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 54 |
| Percent Of With Osteoporosis | 19 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 0 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.2616 |