| National Provider Identifier [NPI]: | 1366407322 |
| Last Name Of The Provider | HARTMAN |
| First Name Of The Provider | KENNETH |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1228 E RUSHOLME ST |
| Street Address 2 Of The Provider | STE 302 |
| City Of The Provider | DAVENPORT |
| Zip Code Of The Provider | 52803 |
| State Code Of The Provider | IA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | General Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 72 |
| Number Of Services | 433 |
| Number Of Medicare Beneficiaries | 208 |
| Total Submitted Charge Amount | 297218 |
| Total Medicare Allowed Amount | 100275.37 |
| Total Medicare Payment Amount | 75808.79 |
| Total Medicare Standardized Payment Amount | 84014.64 |
| 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 | 72 |
| Number Of Medical Services | 433 |
| Number Of Medicare Beneficiaries With Medical Services | 208 |
| Total Medical Submitted Charge Amount | 297218 |
| Total Medical Medicare Allowed Amount | 100275.37 |
| Total Medical Medicare Payment Amount | 75808.79 |
| Total Medical Medicare Standardized Payment Amount | 84014.64 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 30 |
| Number Of Beneficiaries Age 65 to 74 | 94 |
| Number Of Beneficiaries Age 75 to 84 | 68 |
| Number Of Beneficiaries Age Greater 84 | 16 |
| Number Of Female Beneficiaries | 122 |
| Number Of Male Beneficiaries | 86 |
| 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 | 174 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 34 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 27 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 61 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 29 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1504 |