| National Provider Identifier [NPI]: | 1003843848 |
| Last Name Of The Provider | AZAN |
| First Name Of The Provider | KENNETH |
| Middle Initial Of The Provider | N |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1718 S INGRAM AVE |
| Street Address 2 Of The Provider | SUITE C |
| City Of The Provider | SEDALIA |
| Zip Code Of The Provider | 653017505 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 72 |
| Number Of Services | 16631 |
| Number Of Medicare Beneficiaries | 1577 |
| Total Submitted Charge Amount | 1017856.5 |
| Total Medicare Allowed Amount | 863896.36 |
| Total Medicare Payment Amount | 638198.56 |
| Total Medicare Standardized Payment Amount | 654552.55 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 370 |
| Number Of Medicare Beneficiaries With Drug Services | 63 |
| Total Drug Submitted ChargeAmount | 2154 |
| Total Drug Medicare AllowedAmount | 1612.98 |
| Total Drug Medicare PaymentAmount | 1245.57 |
| Total Drug Medicare Standardized Payment Amount | 1245.57 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 70 |
| Number Of Medical Services | 16261 |
| Number Of Medicare Beneficiaries With Medical Services | 1577 |
| Total Medical Submitted Charge Amount | 1015702.5 |
| Total Medical Medicare Allowed Amount | 862283.38 |
| Total Medical Medicare Payment Amount | 636952.99 |
| Total Medical Medicare Standardized Payment Amount | 653306.98 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 205 |
| Number Of Beneficiaries Age 65 to 74 | 492 |
| Number Of Beneficiaries Age 75 to 84 | 565 |
| Number Of Beneficiaries Age Greater 84 | 315 |
| Number Of Female Beneficiaries | 895 |
| Number Of Male Beneficiaries | 682 |
| Number Of Non Hispanic White Beneficiaries | 1508 |
| Number Of Black or African American Beneficiaries | 42 |
| 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 | 1243 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 334 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 36 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 40 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 44 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 56 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.5242 |