| National Provider Identifier [NPI]: | 1346482684 |
| Last Name Of The Provider | TENBRINK |
| First Name Of The Provider | KELLY |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5301 S CONGRESS AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | ATLANTIS |
| Zip Code Of The Provider | 334621149 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 36 |
| Number Of Services | 1172 |
| Number Of Medicare Beneficiaries | 1008 |
| Total Submitted Charge Amount | 1288365 |
| Total Medicare Allowed Amount | 195921.91 |
| Total Medicare Payment Amount | 150744.9 |
| Total Medicare Standardized Payment Amount | 142367.03 |
| 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 | 36 |
| Number Of Medical Services | 1172 |
| Number Of Medicare Beneficiaries With Medical Services | 1008 |
| Total Medical Submitted Charge Amount | 1288365 |
| Total Medical Medicare Allowed Amount | 195921.91 |
| Total Medical Medicare Payment Amount | 150744.9 |
| Total Medical Medicare Standardized Payment Amount | 142367.03 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 211 |
| Number Of Beneficiaries Age 65 to 74 | 223 |
| Number Of Beneficiaries Age 75 to 84 | 272 |
| Number Of Beneficiaries Age Greater 84 | 302 |
| Number Of Female Beneficiaries | 545 |
| Number Of Male Beneficiaries | 463 |
| Number Of Non Hispanic White Beneficiaries | 794 |
| Number Of Black or African American Beneficiaries | 84 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 112 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 658 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 350 |
| Percent Of With Atrial Fibrillation | 25 |
| Percent Of With Alzheimers Disease or Dementia | 30 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 39 |
| Percent Of With Chronic Kidney Disease | 45 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 40 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 62 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 14 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 2.1123 |