| National Provider Identifier [NPI]: | 1578751582 |
| Last Name Of The Provider | GIRA |
| First Name Of The Provider | KELLY |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | PA-C |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 9349 PARK WEST BLVD |
| Street Address 2 Of The Provider | SUITE 202 |
| City Of The Provider | KNOXVILLE |
| Zip Code Of The Provider | 379234306 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 39 |
| Number Of Services | 946 |
| Number Of Medicare Beneficiaries | 295 |
| Total Submitted Charge Amount | 105470.85 |
| Total Medicare Allowed Amount | 45925.73 |
| Total Medicare Payment Amount | 32991.12 |
| Total Medicare Standardized Payment Amount | 42451.35 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 84 |
| Number Of Medicare Beneficiaries With Drug Services | 71 |
| Total Drug Submitted ChargeAmount | 2105.85 |
| Total Drug Medicare AllowedAmount | 1119.44 |
| Total Drug Medicare PaymentAmount | 1051.09 |
| Total Drug Medicare Standardized Payment Amount | 1051.09 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 28 |
| Number Of Medical Services | 862 |
| Number Of Medicare Beneficiaries With Medical Services | 295 |
| Total Medical Submitted Charge Amount | 103365 |
| Total Medical Medicare Allowed Amount | 44806.29 |
| Total Medical Medicare Payment Amount | 31940.03 |
| Total Medical Medicare Standardized Payment Amount | 41400.26 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 62 |
| Number Of Beneficiaries Age 65 to 74 | 135 |
| Number Of Beneficiaries Age 75 to 84 | 68 |
| Number Of Beneficiaries Age Greater 84 | 30 |
| Number Of Female Beneficiaries | 159 |
| Number Of Male Beneficiaries | 136 |
| Number Of Non Hispanic White Beneficiaries | 284 |
| 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 | 236 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 59 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 61 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0508 |