| National Provider Identifier [NPI]: | 1598906000 |
| Last Name Of The Provider | KELLERMAN |
| First Name Of The Provider | JOSHUA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 210 ARK RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | MOUNT LAUREL |
| Zip Code Of The Provider | 080543188 |
| State Code Of The Provider | NJ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 210 |
| Number Of Services | 26299 |
| Number Of Medicare Beneficiaries | 4689 |
| Total Submitted Charge Amount | 2558057.2 |
| Total Medicare Allowed Amount | 699714.53 |
| Total Medicare Payment Amount | 543855.03 |
| Total Medicare Standardized Payment Amount | 515838.84 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 18777 |
| Number Of Medicare Beneficiaries With Drug Services | 274 |
| Total Drug Submitted ChargeAmount | 31142.8 |
| Total Drug Medicare AllowedAmount | 6955.47 |
| Total Drug Medicare PaymentAmount | 5235.5 |
| Total Drug Medicare Standardized Payment Amount | 5235.5 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 205 |
| Number Of Medical Services | 7522 |
| Number Of Medicare Beneficiaries With Medical Services | 4689 |
| Total Medical Submitted Charge Amount | 2526914.4 |
| Total Medical Medicare Allowed Amount | 692759.06 |
| Total Medical Medicare Payment Amount | 538619.53 |
| Total Medical Medicare Standardized Payment Amount | 510603.34 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 497 |
| Number Of Beneficiaries Age 65 to 74 | 1833 |
| Number Of Beneficiaries Age 75 to 84 | 1610 |
| Number Of Beneficiaries Age Greater 84 | 749 |
| Number Of Female Beneficiaries | 2930 |
| Number Of Male Beneficiaries | 1759 |
| Number Of Non Hispanic White Beneficiaries | 4325 |
| Number Of Black or African American Beneficiaries | 155 |
| Number Of AsianPacific Islander Beneficiaries | 25 |
| Number Of Hispanic Beneficiaries | 138 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 46 |
| Number Of Beneficiaries With Medicare Only Entitlement | 4202 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 487 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 33 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 50 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.6427 |