| National Provider Identifier [NPI]: | 1043221856 |
| Last Name Of The Provider | WARREN |
| First Name Of The Provider | KENNETH |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 31 PHYSICIANS DR |
| Street Address 2 Of The Provider | SUITE 1 |
| City Of The Provider | JACKSON |
| Zip Code Of The Provider | 383052071 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 43 |
| Number Of Services | 2840 |
| Number Of Medicare Beneficiaries | 318 |
| Total Submitted Charge Amount | 313115 |
| Total Medicare Allowed Amount | 121177.77 |
| Total Medicare Payment Amount | 83735.16 |
| Total Medicare Standardized Payment Amount | 90634.03 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 12 |
| Number Of Drug Services | 1236 |
| Number Of Medicare Beneficiaries With Drug Services | 99 |
| Total Drug Submitted ChargeAmount | 41031 |
| Total Drug Medicare AllowedAmount | 12083.55 |
| Total Drug Medicare PaymentAmount | 9745.06 |
| Total Drug Medicare Standardized Payment Amount | 9745.06 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 31 |
| Number Of Medical Services | 1604 |
| Number Of Medicare Beneficiaries With Medical Services | 318 |
| Total Medical Submitted Charge Amount | 272084 |
| Total Medical Medicare Allowed Amount | 109094.22 |
| Total Medical Medicare Payment Amount | 73990.1 |
| Total Medical Medicare Standardized Payment Amount | 80888.97 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 65 |
| Number Of Beneficiaries Age 65 to 74 | 127 |
| Number Of Beneficiaries Age 75 to 84 | 92 |
| Number Of Beneficiaries Age Greater 84 | 34 |
| Number Of Female Beneficiaries | 148 |
| Number Of Male Beneficiaries | 170 |
| Number Of Non Hispanic White Beneficiaries | 274 |
| 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 | 252 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 66 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0801 |