| National Provider Identifier [NPI]: | 1952345522 |
| Last Name Of The Provider | KELLEHER |
| First Name Of The Provider | PATRICK |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1036 ACE DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | BEREA |
| Zip Code Of The Provider | 404031327 |
| State Code Of The Provider | KY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 60 |
| Number Of Services | 3604 |
| Number Of Medicare Beneficiaries | 564 |
| Total Submitted Charge Amount | 255710.4 |
| Total Medicare Allowed Amount | 222456.7 |
| Total Medicare Payment Amount | 162585.11 |
| Total Medicare Standardized Payment Amount | 176486.39 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 413 |
| Number Of Medicare Beneficiaries With Drug Services | 255 |
| Total Drug Submitted ChargeAmount | 23201.51 |
| Total Drug Medicare AllowedAmount | 23199.09 |
| Total Drug Medicare PaymentAmount | 22726.62 |
| Total Drug Medicare Standardized Payment Amount | 22726.62 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 53 |
| Number Of Medical Services | 3191 |
| Number Of Medicare Beneficiaries With Medical Services | 564 |
| Total Medical Submitted Charge Amount | 232508.89 |
| Total Medical Medicare Allowed Amount | 199257.61 |
| Total Medical Medicare Payment Amount | 139858.49 |
| Total Medical Medicare Standardized Payment Amount | 153759.77 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 77 |
| Number Of Beneficiaries Age 65 to 74 | 193 |
| Number Of Beneficiaries Age 75 to 84 | 192 |
| Number Of Beneficiaries Age Greater 84 | 102 |
| Number Of Female Beneficiaries | 331 |
| Number Of Male Beneficiaries | 233 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | 423 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 141 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 34 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.3688 |