| National Provider Identifier [NPI]: | 1326186131 |
| Last Name Of The Provider | KENNEDY |
| First Name Of The Provider | SARAH |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | DO |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 855 MONTGOMERY ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | FORT WORTH |
| Zip Code Of The Provider | 761072553 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Sports Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 35 |
| Number Of Services | 219 |
| Number Of Medicare Beneficiaries | 80 |
| Total Submitted Charge Amount | 40980 |
| Total Medicare Allowed Amount | 16460.64 |
| Total Medicare Payment Amount | 12283.73 |
| Total Medicare Standardized Payment Amount | 12245.52 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 22 |
| Number Of Medicare Beneficiaries With Drug Services | 15 |
| Total Drug Submitted ChargeAmount | 2168 |
| Total Drug Medicare AllowedAmount | 973.05 |
| Total Drug Medicare PaymentAmount | 774.61 |
| Total Drug Medicare Standardized Payment Amount | 774.61 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 30 |
| Number Of Medical Services | 197 |
| Number Of Medicare Beneficiaries With Medical Services | 80 |
| Total Medical Submitted Charge Amount | 38812 |
| Total Medical Medicare Allowed Amount | 15487.59 |
| Total Medical Medicare Payment Amount | 11509.12 |
| Total Medical Medicare Standardized Payment Amount | 11470.91 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 22 |
| Number Of Beneficiaries Age 65 to 74 | 35 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 56 |
| Number Of Male Beneficiaries | 24 |
| Number Of Non Hispanic White Beneficiaries | 45 |
| Number Of Black or African American Beneficiaries | 16 |
| 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 | 53 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 27 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 61 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.2461 |