| National Provider Identifier [NPI]: | 1023124609 |
| Last Name Of The Provider | KALISH |
| First Name Of The Provider | KEITH |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | DPM |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2500 QUINCY AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | FORT PIERCE |
| Zip Code Of The Provider | 349474766 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 62 |
| Number Of Services | 8935 |
| Number Of Medicare Beneficiaries | 1690 |
| Total Submitted Charge Amount | 585765.5 |
| Total Medicare Allowed Amount | 525594.61 |
| Total Medicare Payment Amount | 378701.63 |
| Total Medicare Standardized Payment Amount | 360574.66 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 491 |
| Number Of Medicare Beneficiaries With Drug Services | 336 |
| Total Drug Submitted ChargeAmount | 3452 |
| Total Drug Medicare AllowedAmount | 2811.95 |
| Total Drug Medicare PaymentAmount | 2138.41 |
| Total Drug Medicare Standardized Payment Amount | 2138.41 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 61 |
| Number Of Medical Services | 8444 |
| Number Of Medicare Beneficiaries With Medical Services | 1690 |
| Total Medical Submitted Charge Amount | 582313.5 |
| Total Medical Medicare Allowed Amount | 522782.66 |
| Total Medical Medicare Payment Amount | 376563.22 |
| Total Medical Medicare Standardized Payment Amount | 358436.25 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 112 |
| Number Of Beneficiaries Age 65 to 74 | 568 |
| Number Of Beneficiaries Age 75 to 84 | 624 |
| Number Of Beneficiaries Age Greater 84 | 386 |
| Number Of Female Beneficiaries | 911 |
| Number Of Male Beneficiaries | 779 |
| Number Of Non Hispanic White Beneficiaries | 1542 |
| Number Of Black or African American Beneficiaries | 100 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 26 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1542 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 148 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 72 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.3312 |