| National Provider Identifier [NPI]: | 1467434357 |
| Last Name Of The Provider | KELLY |
| First Name Of The Provider | SCOTT |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | OAKLAWN HOSPITAL |
| Street Address 2 Of The Provider | 200 N. MADISON ST. |
| City Of The Provider | MARSHALL |
| Zip Code Of The Provider | 49068 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 29 |
| Number Of Services | 927 |
| Number Of Medicare Beneficiaries | 772 |
| Total Submitted Charge Amount | 631508 |
| Total Medicare Allowed Amount | 135924.7 |
| Total Medicare Payment Amount | 102232.38 |
| Total Medicare Standardized Payment Amount | 103770.22 |
| 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 | 29 |
| Number Of Medical Services | 927 |
| Number Of Medicare Beneficiaries With Medical Services | 772 |
| Total Medical Submitted Charge Amount | 631508 |
| Total Medical Medicare Allowed Amount | 135924.7 |
| Total Medical Medicare Payment Amount | 102232.38 |
| Total Medical Medicare Standardized Payment Amount | 103770.22 |
| Average Age Of Beneficiaries | 66 |
| Number Of Beneficiaries Age Less65 | 308 |
| Number Of Beneficiaries Age 65 to 74 | 205 |
| Number Of Beneficiaries Age 75 to 84 | 149 |
| Number Of Beneficiaries Age Greater 84 | 110 |
| Number Of Female Beneficiaries | 414 |
| Number Of Male Beneficiaries | 358 |
| Number Of Non Hispanic White Beneficiaries | 656 |
| Number Of Black or African American Beneficiaries | 88 |
| 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 | 16 |
| Number Of Beneficiaries With Medicare Only Entitlement | 410 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 362 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 37 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 37 |
| Percent Of With Depression | 43 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 53 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 13 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.9803 |