| National Provider Identifier [NPI]: | 1720063993 |
| Last Name Of The Provider | BERDICK |
| First Name Of The Provider | KENNETH |
| 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 | 3714 EVANS AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | FORT MYERS |
| Zip Code Of The Provider | 339019303 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 62 |
| Number Of Services | 10362 |
| Number Of Medicare Beneficiaries | 947 |
| Total Submitted Charge Amount | 990466.27 |
| Total Medicare Allowed Amount | 736622.62 |
| Total Medicare Payment Amount | 534734.03 |
| Total Medicare Standardized Payment Amount | 554642.47 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 1128 |
| Number Of Medicare Beneficiaries With Drug Services | 462 |
| Total Drug Submitted ChargeAmount | 11351.92 |
| Total Drug Medicare AllowedAmount | 4833.99 |
| Total Drug Medicare PaymentAmount | 3758.09 |
| Total Drug Medicare Standardized Payment Amount | 3758.09 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 57 |
| Number Of Medical Services | 9234 |
| Number Of Medicare Beneficiaries With Medical Services | 947 |
| Total Medical Submitted Charge Amount | 979114.35 |
| Total Medical Medicare Allowed Amount | 731788.63 |
| Total Medical Medicare Payment Amount | 530975.94 |
| Total Medical Medicare Standardized Payment Amount | 550884.38 |
| Average Age Of Beneficiaries | 61 |
| Number Of Beneficiaries Age Less65 | 504 |
| Number Of Beneficiaries Age 65 to 74 | 264 |
| Number Of Beneficiaries Age 75 to 84 | 133 |
| Number Of Beneficiaries Age Greater 84 | 46 |
| Number Of Female Beneficiaries | 528 |
| Number Of Male Beneficiaries | 419 |
| Number Of Non Hispanic White Beneficiaries | 626 |
| Number Of Black or African American Beneficiaries | 173 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 129 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 342 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 605 |
| Percent Of With Atrial Fibrillation | 4 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 19 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 42 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 44 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.5253 |