| National Provider Identifier [NPI]: | 1578785945 |
| Last Name Of The Provider | SHELBY-KENNEDY |
| First Name Of The Provider | HANNAH |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2863 HIGHWAY 45 BYP |
| Street Address 2 Of The Provider | |
| City Of The Provider | JACKSON |
| Zip Code Of The Provider | 383053618 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 86 |
| Number Of Services | 3384 |
| Number Of Medicare Beneficiaries | 194 |
| Total Submitted Charge Amount | 149340 |
| Total Medicare Allowed Amount | 67011.42 |
| Total Medicare Payment Amount | 51063.86 |
| Total Medicare Standardized Payment Amount | 54851.72 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 15 |
| Number Of Drug Services | 1343 |
| Number Of Medicare Beneficiaries With Drug Services | 62 |
| Total Drug Submitted ChargeAmount | 20807 |
| Total Drug Medicare AllowedAmount | 10324.67 |
| Total Drug Medicare PaymentAmount | 8339.34 |
| Total Drug Medicare Standardized Payment Amount | 8339.34 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 71 |
| Number Of Medical Services | 2041 |
| Number Of Medicare Beneficiaries With Medical Services | 194 |
| Total Medical Submitted Charge Amount | 128533 |
| Total Medical Medicare Allowed Amount | 56686.75 |
| Total Medical Medicare Payment Amount | 42724.52 |
| Total Medical Medicare Standardized Payment Amount | 46512.38 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 19 |
| Number Of Beneficiaries Age 65 to 74 | 79 |
| Number Of Beneficiaries Age 75 to 84 | 65 |
| Number Of Beneficiaries Age Greater 84 | 31 |
| Number Of Female Beneficiaries | 161 |
| Number Of Male Beneficiaries | 33 |
| Number Of Non Hispanic White Beneficiaries | 174 |
| 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 | 174 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 20 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 30 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1317 |