| National Provider Identifier [NPI]: | 1801817499 |
| Last Name Of The Provider | KELLER |
| First Name Of The Provider | PATRICK |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 725 AMERICAN AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | WAUKESHA |
| Zip Code Of The Provider | 531885031 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 194 |
| Number Of Services | 7175 |
| Number Of Medicare Beneficiaries | 3190 |
| Total Submitted Charge Amount | 1016142.54 |
| Total Medicare Allowed Amount | 183428 |
| Total Medicare Payment Amount | 139237.31 |
| Total Medicare Standardized Payment Amount | 146089.04 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 1669 |
| Number Of Medicare Beneficiaries With Drug Services | 17 |
| Total Drug Submitted ChargeAmount | 10931 |
| Total Drug Medicare AllowedAmount | 460.41 |
| Total Drug Medicare PaymentAmount | 360.93 |
| Total Drug Medicare Standardized Payment Amount | 360.93 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 192 |
| Number Of Medical Services | 5506 |
| Number Of Medicare Beneficiaries With Medical Services | 3190 |
| Total Medical Submitted Charge Amount | 1005211.54 |
| Total Medical Medicare Allowed Amount | 182967.59 |
| Total Medical Medicare Payment Amount | 138876.38 |
| Total Medical Medicare Standardized Payment Amount | 145728.11 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 390 |
| Number Of Beneficiaries Age 65 to 74 | 1323 |
| Number Of Beneficiaries Age 75 to 84 | 906 |
| Number Of Beneficiaries Age Greater 84 | 571 |
| Number Of Female Beneficiaries | 2005 |
| Number Of Male Beneficiaries | 1185 |
| Number Of Non Hispanic White Beneficiaries | 3054 |
| Number Of Black or African American Beneficiaries | 21 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 53 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 44 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2701 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 489 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.4164 |