| National Provider Identifier [NPI]: | 1619944113 |
| Last Name Of The Provider | KELLY |
| First Name Of The Provider | GEORGE |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7200 CATHEDRAL ROCK DR |
| Street Address 2 Of The Provider | #110 |
| City Of The Provider | LAS VEGAS |
| Zip Code Of The Provider | 891280438 |
| State Code Of The Provider | NV |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Rheumatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 50 |
| Number Of Services | 109279 |
| Number Of Medicare Beneficiaries | 667 |
| Total Submitted Charge Amount | 2381115.59 |
| Total Medicare Allowed Amount | 2334288.38 |
| Total Medicare Payment Amount | 1812641.23 |
| Total Medicare Standardized Payment Amount | 1807163.73 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 24 |
| Number Of Drug Services | 105102 |
| Number Of Medicare Beneficiaries With Drug Services | 281 |
| Total Drug Submitted ChargeAmount | 2049034.76 |
| Total Drug Medicare AllowedAmount | 2010329.72 |
| Total Drug Medicare PaymentAmount | 1574654.8 |
| Total Drug Medicare Standardized Payment Amount | 1574654.8 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 26 |
| Number Of Medical Services | 4177 |
| Number Of Medicare Beneficiaries With Medical Services | 667 |
| Total Medical Submitted Charge Amount | 332080.83 |
| Total Medical Medicare Allowed Amount | 323958.66 |
| Total Medical Medicare Payment Amount | 237986.43 |
| Total Medical Medicare Standardized Payment Amount | 232508.93 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 103 |
| Number Of Beneficiaries Age 65 to 74 | 334 |
| Number Of Beneficiaries Age 75 to 84 | 185 |
| Number Of Beneficiaries Age Greater 84 | 45 |
| Number Of Female Beneficiaries | 510 |
| Number Of Male Beneficiaries | 157 |
| Number Of Non Hispanic White Beneficiaries | 493 |
| Number Of Black or African American Beneficiaries | 80 |
| Number Of AsianPacific Islander Beneficiaries | 26 |
| Number Of Hispanic Beneficiaries | 42 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 620 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 47 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 62 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 27 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.3943 |