| National Provider Identifier [NPI]: | 1891970620 |
| Last Name Of The Provider | THIEM |
| First Name Of The Provider | KENDRA |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | PA-C |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2222 SOUTH 16TH STREET |
| Street Address 2 Of The Provider | SUITE 240 |
| City Of The Provider | LINCOLN |
| Zip Code Of The Provider | 685023764 |
| State Code Of The Provider | NE |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 96 |
| Number Of Services | 1340 |
| Number Of Medicare Beneficiaries | 317 |
| Total Submitted Charge Amount | 614582 |
| Total Medicare Allowed Amount | 73770.76 |
| Total Medicare Payment Amount | 54338.95 |
| Total Medicare Standardized Payment Amount | 69426.71 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 103 |
| Number Of Medicare Beneficiaries With Drug Services | 52 |
| Total Drug Submitted ChargeAmount | 3125 |
| Total Drug Medicare AllowedAmount | 481.87 |
| Total Drug Medicare PaymentAmount | 351.1 |
| Total Drug Medicare Standardized Payment Amount | 351.1 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 94 |
| Number Of Medical Services | 1237 |
| Number Of Medicare Beneficiaries With Medical Services | 317 |
| Total Medical Submitted Charge Amount | 611457 |
| Total Medical Medicare Allowed Amount | 73288.89 |
| Total Medical Medicare Payment Amount | 53987.85 |
| Total Medical Medicare Standardized Payment Amount | 69075.61 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 54 |
| Number Of Beneficiaries Age 65 to 74 | 105 |
| Number Of Beneficiaries Age 75 to 84 | 92 |
| Number Of Beneficiaries Age Greater 84 | 66 |
| Number Of Female Beneficiaries | 189 |
| Number Of Male Beneficiaries | 128 |
| Number Of Non Hispanic White Beneficiaries | 303 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| 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 | 236 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 81 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 43 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 64 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.2565 |