| National Provider Identifier [NPI]: | 1629094404 |
| Last Name Of The Provider | KETLER |
| First Name Of The Provider | PATRICIA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | RN, MSN, APRN, BC |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 104 PLUMTREE RD |
| Street Address 2 Of The Provider | SUITE 115 |
| City Of The Provider | BEL AIR |
| Zip Code Of The Provider | 210156095 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 38 |
| Number Of Services | 860 |
| Number Of Medicare Beneficiaries | 188 |
| Total Submitted Charge Amount | 99848.01 |
| Total Medicare Allowed Amount | 47362.26 |
| Total Medicare Payment Amount | 36069.79 |
| Total Medicare Standardized Payment Amount | 39957.22 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 46 |
| Number Of Medicare Beneficiaries With Drug Services | 40 |
| Total Drug Submitted ChargeAmount | 3332.01 |
| Total Drug Medicare AllowedAmount | 1781.74 |
| Total Drug Medicare PaymentAmount | 1746.01 |
| Total Drug Medicare Standardized Payment Amount | 1746.01 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 32 |
| Number Of Medical Services | 814 |
| Number Of Medicare Beneficiaries With Medical Services | 188 |
| Total Medical Submitted Charge Amount | 96516 |
| Total Medical Medicare Allowed Amount | 45580.52 |
| Total Medical Medicare Payment Amount | 34323.78 |
| Total Medical Medicare Standardized Payment Amount | 38211.21 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 31 |
| Number Of Beneficiaries Age 65 to 74 | 87 |
| Number Of Beneficiaries Age 75 to 84 | 53 |
| Number Of Beneficiaries Age Greater 84 | 17 |
| Number Of Female Beneficiaries | 154 |
| Number Of Male Beneficiaries | 34 |
| Number Of Non Hispanic White Beneficiaries | 167 |
| 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 | 167 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 21 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8223 |