| National Provider Identifier [NPI]: | 1326056359 |
| Last Name Of The Provider | KAFRISSEN |
| First Name Of The Provider | STEVEN |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 562 WYOMING AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | KINGSTON |
| Zip Code Of The Provider | 18704 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Psychiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 11 |
| Number Of Services | 4265 |
| Number Of Medicare Beneficiaries | 776 |
| Total Submitted Charge Amount | 879256 |
| Total Medicare Allowed Amount | 324442.96 |
| Total Medicare Payment Amount | 234922.29 |
| Total Medicare Standardized Payment Amount | 241578.9 |
| 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 | 11 |
| Number Of Medical Services | 4265 |
| Number Of Medicare Beneficiaries With Medical Services | 776 |
| Total Medical Submitted Charge Amount | 879256 |
| Total Medical Medicare Allowed Amount | 324442.96 |
| Total Medical Medicare Payment Amount | 234922.29 |
| Total Medical Medicare Standardized Payment Amount | 241578.9 |
| Average Age Of Beneficiaries | 51 |
| Number Of Beneficiaries Age Less65 | 647 |
| Number Of Beneficiaries Age 65 to 74 | 108 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 415 |
| Number Of Male Beneficiaries | 361 |
| Number Of Non Hispanic White Beneficiaries | 699 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 36 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 153 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 623 |
| Percent Of With Atrial Fibrillation | 2 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 3 |
| Percent Of With Heart Failure | 6 |
| Percent Of With Chronic Kidney Disease | 10 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 68 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 42 |
| Percent Of With Hypertension | 43 |
| Percent Of With Ischemic Heart Disease | 19 |
| Percent Of With Osteoporosis | 3 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 26 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 33 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.1412 |