| National Provider Identifier [NPI]: | 1407959422 |
| Last Name Of The Provider | WHITE |
| First Name Of The Provider | KEITH |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1430 MONMOUTH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | INDEPENDENCE |
| Zip Code Of The Provider | 97351 |
| State Code Of The Provider | OR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 44 |
| Number Of Services | 687 |
| Number Of Medicare Beneficiaries | 92 |
| Total Submitted Charge Amount | 51292.04 |
| Total Medicare Allowed Amount | 37581.76 |
| Total Medicare Payment Amount | 25287.73 |
| Total Medicare Standardized Payment Amount | 28351.31 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 12 |
| Number Of Drug Services | 148 |
| Number Of Medicare Beneficiaries With Drug Services | 23 |
| Total Drug Submitted ChargeAmount | 1254 |
| Total Drug Medicare AllowedAmount | 613.89 |
| Total Drug Medicare PaymentAmount | 542.1 |
| Total Drug Medicare Standardized Payment Amount | 542.1 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 32 |
| Number Of Medical Services | 539 |
| Number Of Medicare Beneficiaries With Medical Services | 92 |
| Total Medical Submitted Charge Amount | 50038.04 |
| Total Medical Medicare Allowed Amount | 36967.87 |
| Total Medical Medicare Payment Amount | 24745.63 |
| Total Medical Medicare Standardized Payment Amount | 27809.21 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 39 |
| Number Of Beneficiaries Age 75 to 84 | 27 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 50 |
| Number Of Male Beneficiaries | 42 |
| Number Of Non Hispanic White Beneficiaries | 81 |
| Number Of Black or African American Beneficiaries | 0 |
| 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 | 80 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 12 |
| 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 | |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 26 |
| Percent Of With Hypertension | 43 |
| Percent Of With Ischemic Heart Disease | |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 25 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9101 |