| National Provider Identifier [NPI]: | 1396748851 |
| Last Name Of The Provider | LADIN |
| First Name Of The Provider | KEVIN |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1331 N 7TH ST |
| Street Address 2 Of The Provider | STE 360 |
| City Of The Provider | PHOENIX |
| Zip Code Of The Provider | 850062772 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physical Medicine and Rehabilitation |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 33 |
| Number Of Services | 535 |
| Number Of Medicare Beneficiaries | 52 |
| Total Submitted Charge Amount | 114347 |
| Total Medicare Allowed Amount | 25954.59 |
| Total Medicare Payment Amount | 19255.59 |
| Total Medicare Standardized Payment Amount | 18957.3 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 292 |
| Number Of Medicare Beneficiaries With Drug Services | 18 |
| Total Drug Submitted ChargeAmount | 8025 |
| Total Drug Medicare AllowedAmount | 1830.84 |
| Total Drug Medicare PaymentAmount | 1412.68 |
| Total Drug Medicare Standardized Payment Amount | 1412.68 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 28 |
| Number Of Medical Services | 243 |
| Number Of Medicare Beneficiaries With Medical Services | 52 |
| Total Medical Submitted Charge Amount | 106322 |
| Total Medical Medicare Allowed Amount | 24123.75 |
| Total Medical Medicare Payment Amount | 17842.91 |
| Total Medical Medicare Standardized Payment Amount | 17544.62 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 12 |
| Number Of Beneficiaries Age 65 to 74 | 27 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 33 |
| Number Of Male Beneficiaries | 19 |
| Number Of Non Hispanic White Beneficiaries | 40 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 39 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 13 |
| 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 | |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 42 |
| Percent Of With Hypertension | 56 |
| Percent Of With Ischemic Heart Disease | |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 62 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 0 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.8396 |