| National Provider Identifier [NPI]: | 1245309442 |
| Last Name Of The Provider | KENNEDY |
| First Name Of The Provider | KATE |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 751 NE BLAKELY DR |
| Street Address 2 Of The Provider | SUITE 4020 |
| City Of The Provider | ISSAQUAH |
| Zip Code Of The Provider | 980296201 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 16 |
| Number Of Services | 6230 |
| Number Of Medicare Beneficiaries | 48 |
| Total Submitted Charge Amount | 142007 |
| Total Medicare Allowed Amount | 52838.42 |
| Total Medicare Payment Amount | 36249.4 |
| Total Medicare Standardized Payment Amount | 39147.12 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 6055 |
| Number Of Medicare Beneficiaries With Drug Services | 14 |
| Total Drug Submitted ChargeAmount | 85110 |
| Total Drug Medicare AllowedAmount | 33510.11 |
| Total Drug Medicare PaymentAmount | 23333.21 |
| Total Drug Medicare Standardized Payment Amount | 23333.21 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 12 |
| Number Of Medical Services | 175 |
| Number Of Medicare Beneficiaries With Medical Services | 48 |
| Total Medical Submitted Charge Amount | 56897 |
| Total Medical Medicare Allowed Amount | 19328.31 |
| Total Medical Medicare Payment Amount | 12916.19 |
| Total Medical Medicare Standardized Payment Amount | 15813.91 |
| Average Age Of Beneficiaries | 58 |
| Number Of Beneficiaries Age Less65 | 27 |
| Number Of Beneficiaries Age 65 to 74 | |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 36 |
| Number Of Male Beneficiaries | 12 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | 27 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 21 |
| 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 | 0 |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 46 |
| Percent Of With Diabetes | |
| Percent Of With Hyperlipidemia | 29 |
| Percent Of With Hypertension | 46 |
| Percent Of With Ischemic Heart Disease | |
| Percent Of With Osteoporosis | 0 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.888 |