| National Provider Identifier [NPI]: | 1164528873 |
| Last Name Of The Provider | HABENICHT |
| First Name Of The Provider | KYMBER |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.C. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1300 CLEVELAND AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | CHATTANOOGA |
| Zip Code Of The Provider | 374042005 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 74 |
| Number Of Services | 8644 |
| Number Of Medicare Beneficiaries | 739 |
| Total Submitted Charge Amount | 765750.1 |
| Total Medicare Allowed Amount | 292401.02 |
| Total Medicare Payment Amount | 217580.1 |
| Total Medicare Standardized Payment Amount | 236994.66 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 4588 |
| Number Of Medicare Beneficiaries With Drug Services | 45 |
| Total Drug Submitted ChargeAmount | 62026.1 |
| Total Drug Medicare AllowedAmount | 22158.85 |
| Total Drug Medicare PaymentAmount | 17166.07 |
| Total Drug Medicare Standardized Payment Amount | 17166.07 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 69 |
| Number Of Medical Services | 4056 |
| Number Of Medicare Beneficiaries With Medical Services | 739 |
| Total Medical Submitted Charge Amount | 703724 |
| Total Medical Medicare Allowed Amount | 270242.17 |
| Total Medical Medicare Payment Amount | 200414.03 |
| Total Medical Medicare Standardized Payment Amount | 219828.59 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 81 |
| Number Of Beneficiaries Age 65 to 74 | 299 |
| Number Of Beneficiaries Age 75 to 84 | 257 |
| Number Of Beneficiaries Age Greater 84 | 102 |
| Number Of Female Beneficiaries | 540 |
| Number Of Male Beneficiaries | 199 |
| Number Of Non Hispanic White Beneficiaries | 667 |
| Number Of Black or African American Beneficiaries | |
| 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 | 582 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 157 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.3588 |