| National Provider Identifier [NPI]: | 1962461707 |
| Last Name Of The Provider | KELLY |
| First Name Of The Provider | OWEN |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 401 N PHOENIX AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | RUSSELLVILLE |
| Zip Code Of The Provider | 728012844 |
| State Code Of The Provider | AR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 128 |
| Number Of Services | 2579 |
| Number Of Medicare Beneficiaries | 578 |
| Total Submitted Charge Amount | 1029453 |
| Total Medicare Allowed Amount | 294792.66 |
| Total Medicare Payment Amount | 217395.88 |
| Total Medicare Standardized Payment Amount | 241285.22 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 481 |
| Number Of Medicare Beneficiaries With Drug Services | 228 |
| Total Drug Submitted ChargeAmount | 13470 |
| Total Drug Medicare AllowedAmount | 6702.74 |
| Total Drug Medicare PaymentAmount | 4885.39 |
| Total Drug Medicare Standardized Payment Amount | 4885.39 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 126 |
| Number Of Medical Services | 2098 |
| Number Of Medicare Beneficiaries With Medical Services | 578 |
| Total Medical Submitted Charge Amount | 1015983 |
| Total Medical Medicare Allowed Amount | 288089.92 |
| Total Medical Medicare Payment Amount | 212510.49 |
| Total Medical Medicare Standardized Payment Amount | 236399.83 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 125 |
| Number Of Beneficiaries Age 65 to 74 | 214 |
| Number Of Beneficiaries Age 75 to 84 | 154 |
| Number Of Beneficiaries Age Greater 84 | 85 |
| Number Of Female Beneficiaries | 393 |
| Number Of Male Beneficiaries | 185 |
| Number Of Non Hispanic White Beneficiaries | 559 |
| Number Of Black or African American Beneficiaries | |
| 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 | 414 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 164 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 38 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 59 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.0513 |