| National Provider Identifier [NPI]: | 1083726269 |
| Last Name Of The Provider | ANDERSON |
| First Name Of The Provider | KEITH |
| Middle Initial Of The Provider | V |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1900 COOKS HILL RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | CENTRALIA |
| Zip Code Of The Provider | 985319073 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 93 |
| Number Of Services | 2144 |
| Number Of Medicare Beneficiaries | 355 |
| Total Submitted Charge Amount | 598558.99 |
| Total Medicare Allowed Amount | 232745.3 |
| Total Medicare Payment Amount | 174056.93 |
| Total Medicare Standardized Payment Amount | 178623.66 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 473 |
| Number Of Medicare Beneficiaries With Drug Services | 124 |
| Total Drug Submitted ChargeAmount | 20967 |
| Total Drug Medicare AllowedAmount | 10299.63 |
| Total Drug Medicare PaymentAmount | 7888.15 |
| Total Drug Medicare Standardized Payment Amount | 7888.15 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 91 |
| Number Of Medical Services | 1671 |
| Number Of Medicare Beneficiaries With Medical Services | 355 |
| Total Medical Submitted Charge Amount | 577591.99 |
| Total Medical Medicare Allowed Amount | 222445.67 |
| Total Medical Medicare Payment Amount | 166168.78 |
| Total Medical Medicare Standardized Payment Amount | 170735.51 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 51 |
| Number Of Beneficiaries Age 65 to 74 | 145 |
| Number Of Beneficiaries Age 75 to 84 | 99 |
| Number Of Beneficiaries Age Greater 84 | 60 |
| Number Of Female Beneficiaries | 214 |
| Number Of Male Beneficiaries | 141 |
| Number Of Non Hispanic White Beneficiaries | 338 |
| 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 | 292 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 63 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 59 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.1127 |