| National Provider Identifier [NPI]: | 1386637122 |
| Last Name Of The Provider | ROBERTS |
| First Name Of The Provider | KENRICK |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 100 WELTON DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | CUMBERLAND |
| Zip Code Of The Provider | 215021336 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 95 |
| Number Of Services | 10518 |
| Number Of Medicare Beneficiaries | 1984 |
| Total Submitted Charge Amount | 1531581.93 |
| Total Medicare Allowed Amount | 863959.93 |
| Total Medicare Payment Amount | 637056.46 |
| Total Medicare Standardized Payment Amount | 621870.88 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 127 |
| Number Of Medicare Beneficiaries With Drug Services | 96 |
| Total Drug Submitted ChargeAmount | 381 |
| Total Drug Medicare AllowedAmount | 226.52 |
| Total Drug Medicare PaymentAmount | 173.2 |
| Total Drug Medicare Standardized Payment Amount | 173.2 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 94 |
| Number Of Medical Services | 10391 |
| Number Of Medicare Beneficiaries With Medical Services | 1984 |
| Total Medical Submitted Charge Amount | 1531200.93 |
| Total Medical Medicare Allowed Amount | 863733.41 |
| Total Medical Medicare Payment Amount | 636883.26 |
| Total Medical Medicare Standardized Payment Amount | 621697.68 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 149 |
| Number Of Beneficiaries Age 65 to 74 | 919 |
| Number Of Beneficiaries Age 75 to 84 | 650 |
| Number Of Beneficiaries Age Greater 84 | 266 |
| Number Of Female Beneficiaries | 892 |
| Number Of Male Beneficiaries | 1092 |
| Number Of Non Hispanic White Beneficiaries | 1954 |
| 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 | 14 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1771 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 213 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.0401 |