| National Provider Identifier [NPI]: | 1518947886 |
| Last Name Of The Provider | LOCKE |
| First Name Of The Provider | KENNETH |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5330 S HIGHWAY 95 |
| Street Address 2 Of The Provider | |
| City Of The Provider | FORT MOHAVE |
| Zip Code Of The Provider | 864269225 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 27 |
| Number Of Services | 1211 |
| Number Of Medicare Beneficiaries | 796 |
| Total Submitted Charge Amount | 892031 |
| Total Medicare Allowed Amount | 130401.17 |
| Total Medicare Payment Amount | 98858.94 |
| Total Medicare Standardized Payment Amount | 100030.91 |
| 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 | 27 |
| Number Of Medical Services | 1211 |
| Number Of Medicare Beneficiaries With Medical Services | 796 |
| Total Medical Submitted Charge Amount | 892031 |
| Total Medical Medicare Allowed Amount | 130401.17 |
| Total Medical Medicare Payment Amount | 98858.94 |
| Total Medical Medicare Standardized Payment Amount | 100030.91 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 142 |
| Number Of Beneficiaries Age 65 to 74 | 325 |
| Number Of Beneficiaries Age 75 to 84 | 246 |
| Number Of Beneficiaries Age Greater 84 | 83 |
| Number Of Female Beneficiaries | 412 |
| Number Of Male Beneficiaries | 384 |
| Number Of Non Hispanic White Beneficiaries | 690 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 64 |
| Number Of American Indian Alaska Native Beneficiaries | 17 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 632 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 164 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 37 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 50 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.5829 |