| National Provider Identifier [NPI]: | 1598863185 |
| Last Name Of The Provider | HESLEY |
| First Name Of The Provider | KERRI |
| 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 | 322 E ANTIETAM ST |
| Street Address 2 Of The Provider | SUITE 106 |
| City Of The Provider | HAGERSTOWN |
| Zip Code Of The Provider | 217405794 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 162 |
| Number Of Services | 16822 |
| Number Of Medicare Beneficiaries | 3673 |
| Total Submitted Charge Amount | 1410438.25 |
| Total Medicare Allowed Amount | 552256.62 |
| Total Medicare Payment Amount | 481608.26 |
| Total Medicare Standardized Payment Amount | 470512.31 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 9962 |
| Number Of Medicare Beneficiaries With Drug Services | 155 |
| Total Drug Submitted ChargeAmount | 13449.25 |
| Total Drug Medicare AllowedAmount | 3874.49 |
| Total Drug Medicare PaymentAmount | 3037.57 |
| Total Drug Medicare Standardized Payment Amount | 3037.57 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 160 |
| Number Of Medical Services | 6860 |
| Number Of Medicare Beneficiaries With Medical Services | 3673 |
| Total Medical Submitted Charge Amount | 1396989 |
| Total Medical Medicare Allowed Amount | 548382.13 |
| Total Medical Medicare Payment Amount | 478570.69 |
| Total Medical Medicare Standardized Payment Amount | 467474.74 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 598 |
| Number Of Beneficiaries Age 65 to 74 | 1621 |
| Number Of Beneficiaries Age 75 to 84 | 1007 |
| Number Of Beneficiaries Age Greater 84 | 447 |
| Number Of Female Beneficiaries | 2955 |
| Number Of Male Beneficiaries | 718 |
| Number Of Non Hispanic White Beneficiaries | 3470 |
| Number Of Black or African American Beneficiaries | 116 |
| Number Of AsianPacific Islander Beneficiaries | 14 |
| Number Of Hispanic Beneficiaries | 42 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 31 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2977 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 696 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.2779 |