| National Provider Identifier [NPI]: | 1205805355 |
| Last Name Of The Provider | KANE |
| First Name Of The Provider | TIMOTHY |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 9 PINNACLE DR |
| Street Address 2 Of The Provider | SUITE 105 |
| City Of The Provider | FISHERSVILLE |
| Zip Code Of The Provider | 229392366 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Psychiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 10 |
| Number Of Services | 4961 |
| Number Of Medicare Beneficiaries | 795 |
| Total Submitted Charge Amount | 524430 |
| Total Medicare Allowed Amount | 427869.04 |
| Total Medicare Payment Amount | 307324.57 |
| Total Medicare Standardized Payment Amount | 312480.72 |
| 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 | 10 |
| Number Of Medical Services | 4961 |
| Number Of Medicare Beneficiaries With Medical Services | 795 |
| Total Medical Submitted Charge Amount | 524430 |
| Total Medical Medicare Allowed Amount | 427869.04 |
| Total Medical Medicare Payment Amount | 307324.57 |
| Total Medical Medicare Standardized Payment Amount | 312480.72 |
| Average Age Of Beneficiaries | 58 |
| Number Of Beneficiaries Age Less65 | 475 |
| Number Of Beneficiaries Age 65 to 74 | 204 |
| Number Of Beneficiaries Age 75 to 84 | 81 |
| Number Of Beneficiaries Age Greater 84 | 35 |
| Number Of Female Beneficiaries | 509 |
| Number Of Male Beneficiaries | 286 |
| Number Of Non Hispanic White Beneficiaries | 723 |
| Number Of Black or African American Beneficiaries | 47 |
| 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 | 13 |
| Number Of Beneficiaries With Medicare Only Entitlement | 410 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 385 |
| Percent Of With Atrial Fibrillation | 3 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 74 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 43 |
| Percent Of With Hypertension | 51 |
| Percent Of With Ischemic Heart Disease | 18 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 28 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 27 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.2759 |