| National Provider Identifier [NPI]: | 1669541827 |
| Last Name Of The Provider | KELLER |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | I |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3633 CAMINO DEL RIO S |
| Street Address 2 Of The Provider | #300 |
| City Of The Provider | SAN DIEGO |
| Zip Code Of The Provider | 921084011 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Rheumatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 95 |
| Number Of Services | 21095 |
| Number Of Medicare Beneficiaries | 1364 |
| Total Submitted Charge Amount | 2499884.4 |
| Total Medicare Allowed Amount | 1199158.88 |
| Total Medicare Payment Amount | 913892.13 |
| Total Medicare Standardized Payment Amount | 895481.28 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 19 |
| Number Of Drug Services | 5977 |
| Number Of Medicare Beneficiaries With Drug Services | 616 |
| Total Drug Submitted ChargeAmount | 298504.9 |
| Total Drug Medicare AllowedAmount | 92316.06 |
| Total Drug Medicare PaymentAmount | 70505.6 |
| Total Drug Medicare Standardized Payment Amount | 70505.6 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 76 |
| Number Of Medical Services | 15118 |
| Number Of Medicare Beneficiaries With Medical Services | 1363 |
| Total Medical Submitted Charge Amount | 2201379.5 |
| Total Medical Medicare Allowed Amount | 1106842.82 |
| Total Medical Medicare Payment Amount | 843386.53 |
| Total Medical Medicare Standardized Payment Amount | 824975.68 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 267 |
| Number Of Beneficiaries Age 65 to 74 | 567 |
| Number Of Beneficiaries Age 75 to 84 | 407 |
| Number Of Beneficiaries Age Greater 84 | 123 |
| Number Of Female Beneficiaries | 1063 |
| Number Of Male Beneficiaries | 301 |
| Number Of Non Hispanic White Beneficiaries | 474 |
| Number Of Black or African American Beneficiaries | 30 |
| Number Of AsianPacific Islander Beneficiaries | 16 |
| Number Of Hispanic Beneficiaries | 826 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 591 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 773 |
| Percent Of With Atrial Fibrillation | 5 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 5 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 39 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.3502 |