| National Provider Identifier [NPI]: | 1033118849 |
| Last Name Of The Provider | CARPENTER |
| First Name Of The Provider | KITRIN |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | PAC |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2020 SILVER CREEK RD |
| Street Address 2 Of The Provider | BLDG A STE 103 |
| City Of The Provider | BULLHEAD CITY |
| Zip Code Of The Provider | 864428476 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 69 |
| Number Of Services | 11164 |
| Number Of Medicare Beneficiaries | 232 |
| Total Submitted Charge Amount | 313303 |
| Total Medicare Allowed Amount | 130463.59 |
| Total Medicare Payment Amount | 101558.3 |
| Total Medicare Standardized Payment Amount | 105530.34 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 41 |
| Number Of Drug Services | 10481 |
| Number Of Medicare Beneficiaries With Drug Services | 67 |
| Total Drug Submitted ChargeAmount | 252611 |
| Total Drug Medicare AllowedAmount | 100855.03 |
| Total Drug Medicare PaymentAmount | 78710 |
| Total Drug Medicare Standardized Payment Amount | 78710 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 28 |
| Number Of Medical Services | 683 |
| Number Of Medicare Beneficiaries With Medical Services | 232 |
| Total Medical Submitted Charge Amount | 60692 |
| Total Medical Medicare Allowed Amount | 29608.56 |
| Total Medical Medicare Payment Amount | 22848.3 |
| Total Medical Medicare Standardized Payment Amount | 26820.34 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 21 |
| Number Of Beneficiaries Age 65 to 74 | 103 |
| Number Of Beneficiaries Age 75 to 84 | 91 |
| Number Of Beneficiaries Age Greater 84 | 17 |
| Number Of Female Beneficiaries | 113 |
| Number Of Male Beneficiaries | 119 |
| Number Of Non Hispanic White Beneficiaries | 206 |
| 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 | 196 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 36 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 38 |
| Percent Of With Heart Failure | 40 |
| Percent Of With Chronic Kidney Disease | 46 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 44 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 2.0959 |