| National Provider Identifier [NPI]: | 1710972385 |
| Last Name Of The Provider | KELLY |
| First Name Of The Provider | KEVIN |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 13150 HIGHWAY 43 |
| Street Address 2 Of The Provider | SUITE 10 |
| City Of The Provider | RUSSELLVILLE |
| Zip Code Of The Provider | 356534558 |
| State Code Of The Provider | AL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 99 |
| Number Of Services | 16526 |
| Number Of Medicare Beneficiaries | 1079 |
| Total Submitted Charge Amount | 764535 |
| Total Medicare Allowed Amount | 503545.63 |
| Total Medicare Payment Amount | 363734.65 |
| Total Medicare Standardized Payment Amount | 394008.1 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 15 |
| Number Of Drug Services | 7411 |
| Number Of Medicare Beneficiaries With Drug Services | 620 |
| Total Drug Submitted ChargeAmount | 91244 |
| Total Drug Medicare AllowedAmount | 13783.2 |
| Total Drug Medicare PaymentAmount | 11667 |
| Total Drug Medicare Standardized Payment Amount | 11667 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 84 |
| Number Of Medical Services | 9115 |
| Number Of Medicare Beneficiaries With Medical Services | 1079 |
| Total Medical Submitted Charge Amount | 673291 |
| Total Medical Medicare Allowed Amount | 489762.43 |
| Total Medical Medicare Payment Amount | 352067.65 |
| Total Medical Medicare Standardized Payment Amount | 382341.1 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 192 |
| Number Of Beneficiaries Age 65 to 74 | 430 |
| Number Of Beneficiaries Age 75 to 84 | 321 |
| Number Of Beneficiaries Age Greater 84 | 136 |
| Number Of Female Beneficiaries | 672 |
| Number Of Male Beneficiaries | 407 |
| Number Of Non Hispanic White Beneficiaries | 971 |
| Number Of Black or African American Beneficiaries | 79 |
| 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 | 703 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 376 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 46 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 3 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.0692 |