| National Provider Identifier [NPI]: | 1558346262 |
| Last Name Of The Provider | STARK |
| First Name Of The Provider | KENNETH |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1613 BANNING BEACH RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | TAVARES |
| Zip Code Of The Provider | 327782024 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Rheumatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 41 |
| Number Of Services | 144605 |
| Number Of Medicare Beneficiaries | 1353 |
| Total Submitted Charge Amount | 2679330.38 |
| Total Medicare Allowed Amount | 2677164.59 |
| Total Medicare Payment Amount | 2079609.93 |
| Total Medicare Standardized Payment Amount | 2079135.5 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 14 |
| Number Of Drug Services | 139566 |
| Number Of Medicare Beneficiaries With Drug Services | 439 |
| Total Drug Submitted ChargeAmount | 2272806.31 |
| Total Drug Medicare AllowedAmount | 2271653.1 |
| Total Drug Medicare PaymentAmount | 1774150.43 |
| Total Drug Medicare Standardized Payment Amount | 1774150.43 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 27 |
| Number Of Medical Services | 5039 |
| Number Of Medicare Beneficiaries With Medical Services | 1353 |
| Total Medical Submitted Charge Amount | 406524.07 |
| Total Medical Medicare Allowed Amount | 405511.49 |
| Total Medical Medicare Payment Amount | 305459.5 |
| Total Medical Medicare Standardized Payment Amount | 304985.07 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 95 |
| Number Of Beneficiaries Age 65 to 74 | 601 |
| Number Of Beneficiaries Age 75 to 84 | 527 |
| Number Of Beneficiaries Age Greater 84 | 130 |
| Number Of Female Beneficiaries | 1056 |
| Number Of Male Beneficiaries | 297 |
| Number Of Non Hispanic White Beneficiaries | 1265 |
| Number Of Black or African American Beneficiaries | 42 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 19 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1268 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 85 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 34 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 69 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.2642 |