| National Provider Identifier [NPI]: | 1881648418 |
| Last Name Of The Provider | KELLOGG |
| First Name Of The Provider | ROGER |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 286 HOSPITAL LOOP |
| Street Address 2 Of The Provider | SUITE 5 |
| City Of The Provider | BERLIN |
| Zip Code Of The Provider | 056029523 |
| State Code Of The Provider | VT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 18 |
| Number Of Services | 2935 |
| Number Of Medicare Beneficiaries | 1302 |
| Total Submitted Charge Amount | 284516 |
| Total Medicare Allowed Amount | 148808.25 |
| Total Medicare Payment Amount | 94397.21 |
| Total Medicare Standardized Payment Amount | 95795.31 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 27 |
| Number Of Medicare Beneficiaries With Drug Services | 27 |
| Total Drug Submitted ChargeAmount | 1080 |
| Total Drug Medicare AllowedAmount | 353.04 |
| Total Drug Medicare PaymentAmount | 346 |
| Total Drug Medicare Standardized Payment Amount | 346 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 16 |
| Number Of Medical Services | 2908 |
| Number Of Medicare Beneficiaries With Medical Services | 1302 |
| Total Medical Submitted Charge Amount | 283436 |
| Total Medical Medicare Allowed Amount | 148455.21 |
| Total Medical Medicare Payment Amount | 94051.21 |
| Total Medical Medicare Standardized Payment Amount | 95449.31 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 170 |
| Number Of Beneficiaries Age 65 to 74 | 400 |
| Number Of Beneficiaries Age 75 to 84 | 435 |
| Number Of Beneficiaries Age Greater 84 | 297 |
| Number Of Female Beneficiaries | 728 |
| Number Of Male Beneficiaries | 574 |
| Number Of Non Hispanic White Beneficiaries | 1260 |
| 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 | 20 |
| Number Of Beneficiaries With Medicare Only Entitlement | 881 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 421 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.3761 |