| National Provider Identifier [NPI]: | 1417925686 |
| Last Name Of The Provider | KEOWN |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 601 1ST ST N |
| Street Address 2 Of The Provider | |
| City Of The Provider | WINTER HAVEN |
| Zip Code Of The Provider | 338814129 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 268 |
| Number Of Services | 17486 |
| Number Of Medicare Beneficiaries | 804 |
| Total Submitted Charge Amount | 826351.1 |
| Total Medicare Allowed Amount | 432445.35 |
| Total Medicare Payment Amount | 343860.74 |
| Total Medicare Standardized Payment Amount | 349850.96 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 30 |
| Number Of Drug Services | 5074 |
| Number Of Medicare Beneficiaries With Drug Services | 421 |
| Total Drug Submitted ChargeAmount | 73704 |
| Total Drug Medicare AllowedAmount | 38714.58 |
| Total Drug Medicare PaymentAmount | 33954.32 |
| Total Drug Medicare Standardized Payment Amount | 33954.32 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 238 |
| Number Of Medical Services | 12412 |
| Number Of Medicare Beneficiaries With Medical Services | 804 |
| Total Medical Submitted Charge Amount | 752647.1 |
| Total Medical Medicare Allowed Amount | 393730.77 |
| Total Medical Medicare Payment Amount | 309906.42 |
| Total Medical Medicare Standardized Payment Amount | 315896.64 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 68 |
| Number Of Beneficiaries Age 65 to 74 | 335 |
| Number Of Beneficiaries Age 75 to 84 | 296 |
| Number Of Beneficiaries Age Greater 84 | 105 |
| Number Of Female Beneficiaries | 447 |
| Number Of Male Beneficiaries | 357 |
| Number Of Non Hispanic White Beneficiaries | 748 |
| Number Of Black or African American Beneficiaries | 31 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 13 |
| Number Of Beneficiaries With Medicare Only Entitlement | 731 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 73 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.2056 |