| National Provider Identifier [NPI]: | 1053662007 |
| Last Name Of The Provider | MCDONALD |
| First Name Of The Provider | KERBY |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | APMHNP |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5000 HIGHWAY 39 N |
| Street Address 2 Of The Provider | SUITE B |
| City Of The Provider | MERIDIAN |
| Zip Code Of The Provider | 393011021 |
| State Code Of The Provider | MS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 7 |
| Number Of Services | 596 |
| Number Of Medicare Beneficiaries | 363 |
| Total Submitted Charge Amount | 38952.8 |
| Total Medicare Allowed Amount | 27131.77 |
| Total Medicare Payment Amount | 18787.54 |
| Total Medicare Standardized Payment Amount | 23958.96 |
| 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 | 7 |
| Number Of Medical Services | 596 |
| Number Of Medicare Beneficiaries With Medical Services | 363 |
| Total Medical Submitted Charge Amount | 38952.8 |
| Total Medical Medicare Allowed Amount | 27131.77 |
| Total Medical Medicare Payment Amount | 18787.54 |
| Total Medical Medicare Standardized Payment Amount | 23958.96 |
| Average Age Of Beneficiaries | 53 |
| Number Of Beneficiaries Age Less65 | 288 |
| Number Of Beneficiaries Age 65 to 74 | |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 192 |
| Number Of Male Beneficiaries | 171 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | 183 |
| 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 | 63 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 300 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 9 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 64 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 38 |
| Percent Of With Hypertension | 58 |
| Percent Of With Ischemic Heart Disease | 12 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 53 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.2001 |