| National Provider Identifier [NPI]: | 1164491957 |
| Last Name Of The Provider | KELLY |
| First Name Of The Provider | SARA |
| Middle Initial Of The Provider | F |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 111 GROSSMAN DR |
| Street Address 2 Of The Provider | INTERNAL MEDICINE |
| City Of The Provider | BRAINTREE |
| Zip Code Of The Provider | 021844997 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 116 |
| Number Of Services | 3284 |
| Number Of Medicare Beneficiaries | 306 |
| Total Submitted Charge Amount | 135076.07 |
| Total Medicare Allowed Amount | 104314.1 |
| Total Medicare Payment Amount | 86927.95 |
| Total Medicare Standardized Payment Amount | 83418.16 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 12 |
| Number Of Drug Services | 198 |
| Number Of Medicare Beneficiaries With Drug Services | 119 |
| Total Drug Submitted ChargeAmount | 9208.07 |
| Total Drug Medicare AllowedAmount | 6734.66 |
| Total Drug Medicare PaymentAmount | 6463.76 |
| Total Drug Medicare Standardized Payment Amount | 6463.76 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 104 |
| Number Of Medical Services | 3086 |
| Number Of Medicare Beneficiaries With Medical Services | 306 |
| Total Medical Submitted Charge Amount | 125868 |
| Total Medical Medicare Allowed Amount | 97579.44 |
| Total Medical Medicare Payment Amount | 80464.19 |
| Total Medical Medicare Standardized Payment Amount | 76954.4 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 53 |
| Number Of Beneficiaries Age 65 to 74 | 158 |
| Number Of Beneficiaries Age 75 to 84 | 71 |
| Number Of Beneficiaries Age Greater 84 | 24 |
| Number Of Female Beneficiaries | 248 |
| Number Of Male Beneficiaries | 58 |
| Number Of Non Hispanic White Beneficiaries | 274 |
| Number Of Black or African American Beneficiaries | 13 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 258 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 48 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 20 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 58 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.9512 |