| National Provider Identifier [NPI]: | 1841280898 |
| Last Name Of The Provider | KAISER |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D. OB/GYN |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 215 E HAWAII AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | NAMPA |
| Zip Code Of The Provider | 836866011 |
| State Code Of The Provider | ID |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Obstetrics/Gynecology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 57 |
| Number Of Services | 550 |
| Number Of Medicare Beneficiaries | 220 |
| Total Submitted Charge Amount | 50077.15 |
| Total Medicare Allowed Amount | 25797.92 |
| Total Medicare Payment Amount | 21997.16 |
| Total Medicare Standardized Payment Amount | 24578.5 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 160 |
| Number Of Medicare Beneficiaries With Drug Services | 160 |
| Total Drug Submitted ChargeAmount | 6015 |
| Total Drug Medicare AllowedAmount | 5164.87 |
| Total Drug Medicare PaymentAmount | 5061.18 |
| Total Drug Medicare Standardized Payment Amount | 5061.18 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 54 |
| Number Of Medical Services | 390 |
| Number Of Medicare Beneficiaries With Medical Services | 220 |
| Total Medical Submitted Charge Amount | 44062.15 |
| Total Medical Medicare Allowed Amount | 20633.05 |
| Total Medical Medicare Payment Amount | 16935.98 |
| Total Medical Medicare Standardized Payment Amount | 19517.32 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 25 |
| Number Of Beneficiaries Age 65 to 74 | 82 |
| Number Of Beneficiaries Age 75 to 84 | 83 |
| Number Of Beneficiaries Age Greater 84 | 30 |
| Number Of Female Beneficiaries | 153 |
| Number Of Male Beneficiaries | 67 |
| 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 | 197 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 23 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 7 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 21 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 17 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 0 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.7793 |