| National Provider Identifier [NPI]: | 1346207537 |
| Last Name Of The Provider | KELLER |
| First Name Of The Provider | PAUL |
| 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 | 12368 STRATFORD DR |
| Street Address 2 Of The Provider | SUITE 300 |
| City Of The Provider | CLIVE |
| Zip Code Of The Provider | 503258162 |
| State Code Of The Provider | IA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 213 |
| Number Of Services | 10134 |
| Number Of Medicare Beneficiaries | 4062 |
| Total Submitted Charge Amount | 580185.5 |
| Total Medicare Allowed Amount | 217180.62 |
| Total Medicare Payment Amount | 171410.88 |
| Total Medicare Standardized Payment Amount | 185521.49 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 3798 |
| Number Of Medicare Beneficiaries With Drug Services | 59 |
| Total Drug Submitted ChargeAmount | 2991.5 |
| Total Drug Medicare AllowedAmount | 1287.42 |
| Total Drug Medicare PaymentAmount | 1009.38 |
| Total Drug Medicare Standardized Payment Amount | 1009.38 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 208 |
| Number Of Medical Services | 6336 |
| Number Of Medicare Beneficiaries With Medical Services | 4062 |
| Total Medical Submitted Charge Amount | 577194 |
| Total Medical Medicare Allowed Amount | 215893.2 |
| Total Medical Medicare Payment Amount | 170401.5 |
| Total Medical Medicare Standardized Payment Amount | 184512.11 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 641 |
| Number Of Beneficiaries Age 65 to 74 | 1515 |
| Number Of Beneficiaries Age 75 to 84 | 1163 |
| Number Of Beneficiaries Age Greater 84 | 743 |
| Number Of Female Beneficiaries | 2667 |
| Number Of Male Beneficiaries | 1395 |
| Number Of Non Hispanic White Beneficiaries | 3798 |
| Number Of Black or African American Beneficiaries | 118 |
| Number Of AsianPacific Islander Beneficiaries | 49 |
| Number Of Hispanic Beneficiaries | 53 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 3179 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 883 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.4187 |