| National Provider Identifier [NPI]: | 1720195258 |
| Last Name Of The Provider | KELLNER |
| First Name Of The Provider | KENNETH |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4061 OLD PESHTIGO RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | MARINETTE |
| Zip Code Of The Provider | 54143 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nephrology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 72 |
| Number Of Services | 7214 |
| Number Of Medicare Beneficiaries | 756 |
| Total Submitted Charge Amount | 1613124.31 |
| Total Medicare Allowed Amount | 413859.32 |
| Total Medicare Payment Amount | 310900.88 |
| Total Medicare Standardized Payment Amount | 325705.28 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 1020 |
| Number Of Medicare Beneficiaries With Drug Services | 27 |
| Total Drug Submitted ChargeAmount | 16634.31 |
| Total Drug Medicare AllowedAmount | 5249.93 |
| Total Drug Medicare PaymentAmount | 3991.82 |
| Total Drug Medicare Standardized Payment Amount | 3991.82 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 65 |
| Number Of Medical Services | 6194 |
| Number Of Medicare Beneficiaries With Medical Services | 756 |
| Total Medical Submitted Charge Amount | 1596490 |
| Total Medical Medicare Allowed Amount | 408609.39 |
| Total Medical Medicare Payment Amount | 306909.06 |
| Total Medical Medicare Standardized Payment Amount | 321713.46 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 157 |
| Number Of Beneficiaries Age 65 to 74 | 217 |
| Number Of Beneficiaries Age 75 to 84 | 241 |
| Number Of Beneficiaries Age Greater 84 | 141 |
| Number Of Female Beneficiaries | 379 |
| Number Of Male Beneficiaries | 377 |
| Number Of Non Hispanic White Beneficiaries | 734 |
| 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 | 559 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 197 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 41 |
| Percent Of With Chronic Kidney Disease | 74 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 47 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 56 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 2.6059 |