| National Provider Identifier [NPI]: | 1447350855 |
| Last Name Of The Provider | ANDERSON |
| First Name Of The Provider | KURT |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | PA-C |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3280 WOODS WAY STE 1 |
| Street Address 2 Of The Provider | |
| City Of The Provider | PETOSKEY |
| Zip Code Of The Provider | 497708105 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 23 |
| Number Of Services | 753 |
| Number Of Medicare Beneficiaries | 255 |
| Total Submitted Charge Amount | 92150 |
| Total Medicare Allowed Amount | 54752.92 |
| Total Medicare Payment Amount | 39312.43 |
| Total Medicare Standardized Payment Amount | 48125.64 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 169 |
| Number Of Medicare Beneficiaries With Drug Services | 66 |
| Total Drug Submitted ChargeAmount | 4466 |
| Total Drug Medicare AllowedAmount | 2106.36 |
| Total Drug Medicare PaymentAmount | 1650.58 |
| Total Drug Medicare Standardized Payment Amount | 1650.58 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 16 |
| Number Of Medical Services | 584 |
| Number Of Medicare Beneficiaries With Medical Services | 255 |
| Total Medical Submitted Charge Amount | 87684 |
| Total Medical Medicare Allowed Amount | 52646.56 |
| Total Medical Medicare Payment Amount | 37661.85 |
| Total Medical Medicare Standardized Payment Amount | 46475.06 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 52 |
| Number Of Beneficiaries Age 65 to 74 | 115 |
| Number Of Beneficiaries Age 75 to 84 | 71 |
| Number Of Beneficiaries Age Greater 84 | 17 |
| Number Of Female Beneficiaries | 178 |
| Number Of Male Beneficiaries | 77 |
| 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 | 233 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 22 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 4 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.2746 |