National Provider Identifier [NPI]: |
1356314991 |
Last Name Of The Provider |
KELLY |
First Name Of The Provider |
CHRISTOPHER |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1830 14TH AVE S |
Street Address 2 Of The Provider |
|
City Of The Provider |
BIRMINGHAM |
Zip Code Of The Provider |
352054969 |
State Code Of The Provider |
AL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Ophthalmology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
18 |
Number Of Services |
1709 |
Number Of Medicare Beneficiaries |
994 |
Total Submitted Charge Amount |
364650 |
Total Medicare Allowed Amount |
208295.5 |
Total Medicare Payment Amount |
145430.13 |
Total Medicare Standardized Payment Amount |
158214.78 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
18 |
Number Of Medical Services |
1709 |
Number Of Medicare Beneficiaries With Medical Services |
994 |
Total Medical Submitted Charge Amount |
364650 |
Total Medical Medicare Allowed Amount |
208295.5 |
Total Medical Medicare Payment Amount |
145430.13 |
Total Medical Medicare Standardized Payment Amount |
158214.78 |
Average Age Of Beneficiaries |
79 |
Number Of Beneficiaries Age Less65 |
14 |
Number Of Beneficiaries Age 65 to 74 |
308 |
Number Of Beneficiaries Age 75 to 84 |
408 |
Number Of Beneficiaries Age Greater 84 |
264 |
Number Of Female Beneficiaries |
641 |
Number Of Male Beneficiaries |
353 |
Number Of Non Hispanic White Beneficiaries |
949 |
Number Of Black or African American Beneficiaries |
33 |
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 |
981 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
13 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
12 |
Percent Of With Diabetes |
20 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
67 |
Percent Of With Ischemic Heart Disease |
27 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
1 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
0.9361 |