| National Provider Identifier [NPI]: | 1730169079 |
| Last Name Of The Provider | KLYNOWSKY-FARRELL |
| First Name Of The Provider | DENISE |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | DO |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 96 WOOD ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | WILKES BARRE |
| Zip Code Of The Provider | 187023612 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 35 |
| Number Of Services | 744 |
| Number Of Medicare Beneficiaries | 205 |
| Total Submitted Charge Amount | 84984 |
| Total Medicare Allowed Amount | 65931.91 |
| Total Medicare Payment Amount | 47480.04 |
| Total Medicare Standardized Payment Amount | 49602.77 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 51 |
| Number Of Medicare Beneficiaries With Drug Services | 33 |
| Total Drug Submitted ChargeAmount | 936 |
| Total Drug Medicare AllowedAmount | 492.44 |
| Total Drug Medicare PaymentAmount | 474.48 |
| Total Drug Medicare Standardized Payment Amount | 474.48 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 32 |
| Number Of Medical Services | 693 |
| Number Of Medicare Beneficiaries With Medical Services | 205 |
| Total Medical Submitted Charge Amount | 84048 |
| Total Medical Medicare Allowed Amount | 65439.47 |
| Total Medical Medicare Payment Amount | 47005.56 |
| Total Medical Medicare Standardized Payment Amount | 49128.29 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 61 |
| Number Of Beneficiaries Age 65 to 74 | 75 |
| Number Of Beneficiaries Age 75 to 84 | 37 |
| Number Of Beneficiaries Age Greater 84 | 32 |
| Number Of Female Beneficiaries | 142 |
| Number Of Male Beneficiaries | 63 |
| Number Of Non Hispanic White Beneficiaries | 194 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 112 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 93 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 12 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.2187 |