| National Provider Identifier [NPI]: | 1235225558 |
| Last Name Of The Provider | KELLER |
| First Name Of The Provider | JON |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 795 EL CAMINO REAL |
| Street Address 2 Of The Provider | |
| City Of The Provider | PALO ALTO |
| Zip Code Of The Provider | 943012302 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pathology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 540 |
| Number Of Services | 454256 |
| Number Of Medicare Beneficiaries | 38699 |
| Total Submitted Charge Amount | 22769061.15 |
| Total Medicare Allowed Amount | 5305246.57 |
| Total Medicare Payment Amount | 5163696.92 |
| Total Medicare Standardized Payment Amount | 5258301.38 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 540 |
| Number Of Medical Services | 454256 |
| Number Of Medicare Beneficiaries With Medical Services | 38699 |
| Total Medical Submitted Charge Amount | 22769061.15 |
| Total Medical Medicare Allowed Amount | 5305246.57 |
| Total Medical Medicare Payment Amount | 5163696.92 |
| Total Medical Medicare Standardized Payment Amount | 5258301.38 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 2777 |
| Number Of Beneficiaries Age 65 to 74 | 19295 |
| Number Of Beneficiaries Age 75 to 84 | 11077 |
| Number Of Beneficiaries Age Greater 84 | 5550 |
| Number Of Female Beneficiaries | 22639 |
| Number Of Male Beneficiaries | 16060 |
| Number Of Non Hispanic White Beneficiaries | 29604 |
| Number Of Black or African American Beneficiaries | 799 |
| Number Of AsianPacific Islander Beneficiaries | 4371 |
| Number Of Hispanic Beneficiaries | 2630 |
| Number Of American Indian Alaska Native Beneficiaries | 25 |
| Number Of Beneficiaries With Race Not Else where Classified | 1270 |
| Number Of Beneficiaries With Medicare Only Entitlement | 33721 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 4978 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 6 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 20 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 50 |
| Percent Of With Ischemic Heart Disease | 20 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 28 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.9145 |