| National Provider Identifier [NPI]: | 1700821436 |
| Last Name Of The Provider | KILLEEN |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1802 BRAEBURN DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | SALEM |
| Zip Code Of The Provider | 241537357 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pulmonary Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 61 |
| Number Of Services | 2585 |
| Number Of Medicare Beneficiaries | 747 |
| Total Submitted Charge Amount | 522299 |
| Total Medicare Allowed Amount | 205092.51 |
| Total Medicare Payment Amount | 153694.58 |
| Total Medicare Standardized Payment Amount | 157481.94 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 30 |
| Number Of Medicare Beneficiaries With Drug Services | 28 |
| Total Drug Submitted ChargeAmount | 6541 |
| Total Drug Medicare AllowedAmount | 2506.07 |
| Total Drug Medicare PaymentAmount | 2449.2 |
| Total Drug Medicare Standardized Payment Amount | 2449.2 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 56 |
| Number Of Medical Services | 2555 |
| Number Of Medicare Beneficiaries With Medical Services | 747 |
| Total Medical Submitted Charge Amount | 515758 |
| Total Medical Medicare Allowed Amount | 202586.44 |
| Total Medical Medicare Payment Amount | 151245.38 |
| Total Medical Medicare Standardized Payment Amount | 155032.74 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 106 |
| Number Of Beneficiaries Age 65 to 74 | 303 |
| Number Of Beneficiaries Age 75 to 84 | 243 |
| Number Of Beneficiaries Age Greater 84 | 95 |
| Number Of Female Beneficiaries | 443 |
| Number Of Male Beneficiaries | 304 |
| Number Of Non Hispanic White Beneficiaries | 685 |
| Number Of Black or African American Beneficiaries | 49 |
| 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 | 608 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 139 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 25 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 37 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 53 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.6998 |