| National Provider Identifier [NPI]: | 1104070457 |
| Last Name Of The Provider | ADAMS |
| First Name Of The Provider | KELLI |
| Middle Initial Of The Provider | N |
| Credentials Of The Provider | NP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5875 THOMPSON MILL RD |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | HOSCHTON |
| Zip Code Of The Provider | 305484133 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 75 |
| Number Of Services | 1509.5 |
| Number Of Medicare Beneficiaries | 358 |
| Total Submitted Charge Amount | 84186.25 |
| Total Medicare Allowed Amount | 37293.2 |
| Total Medicare Payment Amount | 26836.29 |
| Total Medicare Standardized Payment Amount | 30349.22 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 18 |
| Number Of Drug Services | 599.5 |
| Number Of Medicare Beneficiaries With Drug Services | 115 |
| Total Drug Submitted ChargeAmount | 2358.75 |
| Total Drug Medicare AllowedAmount | 604.09 |
| Total Drug Medicare PaymentAmount | 459.1 |
| Total Drug Medicare Standardized Payment Amount | 459.1 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 57 |
| Number Of Medical Services | 910 |
| Number Of Medicare Beneficiaries With Medical Services | 358 |
| Total Medical Submitted Charge Amount | 81827.5 |
| Total Medical Medicare Allowed Amount | 36689.11 |
| Total Medical Medicare Payment Amount | 26377.19 |
| Total Medical Medicare Standardized Payment Amount | 29890.12 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 30 |
| Number Of Beneficiaries Age 65 to 74 | 196 |
| Number Of Beneficiaries Age 75 to 84 | 87 |
| Number Of Beneficiaries Age Greater 84 | 45 |
| Number Of Female Beneficiaries | 226 |
| Number Of Male Beneficiaries | 132 |
| Number Of Non Hispanic White Beneficiaries | 344 |
| Number Of Black or African American Beneficiaries | |
| 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 | 341 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 17 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.9579 |