| National Provider Identifier [NPI]: | 1255489415 |
| Last Name Of The Provider | KENDRICK |
| First Name Of The Provider | JACK |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 117 OAK RIDGE CT |
| Street Address 2 Of The Provider | |
| City Of The Provider | PRESTONSBURG |
| Zip Code Of The Provider | 416538607 |
| State Code Of The Provider | KY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 38 |
| Number Of Services | 4757 |
| Number Of Medicare Beneficiaries | 1217 |
| Total Submitted Charge Amount | 378125.04 |
| Total Medicare Allowed Amount | 246802.91 |
| Total Medicare Payment Amount | 176065.77 |
| Total Medicare Standardized Payment Amount | 177509.69 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 537 |
| Number Of Medicare Beneficiaries With Drug Services | 127 |
| Total Drug Submitted ChargeAmount | 13029 |
| Total Drug Medicare AllowedAmount | 1964.81 |
| Total Drug Medicare PaymentAmount | 1625.41 |
| Total Drug Medicare Standardized Payment Amount | 1625.41 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 32 |
| Number Of Medical Services | 4220 |
| Number Of Medicare Beneficiaries With Medical Services | 1217 |
| Total Medical Submitted Charge Amount | 365096.04 |
| Total Medical Medicare Allowed Amount | 244838.1 |
| Total Medical Medicare Payment Amount | 174440.36 |
| Total Medical Medicare Standardized Payment Amount | 175884.28 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 359 |
| Number Of Beneficiaries Age 65 to 74 | 425 |
| Number Of Beneficiaries Age 75 to 84 | 298 |
| Number Of Beneficiaries Age Greater 84 | 135 |
| Number Of Female Beneficiaries | 666 |
| Number Of Male Beneficiaries | 551 |
| 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 | 640 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 577 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 23 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 33 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 52 |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 46 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 59 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 57 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 12 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.6727 |