| National Provider Identifier [NPI]: | 1316154644 |
| Last Name Of The Provider | MCGUIGAN |
| First Name Of The Provider | KELLY |
| 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 | 101 RIDGELY AVE |
| Street Address 2 Of The Provider | SUITE 10 |
| City Of The Provider | ANNAPOLIS |
| Zip Code Of The Provider | 214011409 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 81 |
| Number Of Services | 4621 |
| Number Of Medicare Beneficiaries | 520 |
| Total Submitted Charge Amount | 516403 |
| Total Medicare Allowed Amount | 319560.86 |
| Total Medicare Payment Amount | 237929.75 |
| Total Medicare Standardized Payment Amount | 221955.68 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 65 |
| Number Of Medicare Beneficiaries With Drug Services | 33 |
| Total Drug Submitted ChargeAmount | 14664 |
| Total Drug Medicare AllowedAmount | 10973.03 |
| Total Drug Medicare PaymentAmount | 8450.52 |
| Total Drug Medicare Standardized Payment Amount | 8450.52 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 79 |
| Number Of Medical Services | 4556 |
| Number Of Medicare Beneficiaries With Medical Services | 520 |
| Total Medical Submitted Charge Amount | 501739 |
| Total Medical Medicare Allowed Amount | 308587.83 |
| Total Medical Medicare Payment Amount | 229479.23 |
| Total Medical Medicare Standardized Payment Amount | 213505.16 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 19 |
| Number Of Beneficiaries Age 65 to 74 | 308 |
| Number Of Beneficiaries Age 75 to 84 | 140 |
| Number Of Beneficiaries Age Greater 84 | 53 |
| Number Of Female Beneficiaries | 316 |
| Number Of Male Beneficiaries | 204 |
| Number Of Non Hispanic White Beneficiaries | 489 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 12 |
| Number Of Beneficiaries With Medicare Only Entitlement | 507 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 13 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 4 |
| Percent Of With Asthma | 3 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 7 |
| Percent Of With Chronic Kidney Disease | 9 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 4 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 55 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.8165 |