| National Provider Identifier [NPI]: | 1306086640 |
| Last Name Of The Provider | KELLY |
| First Name Of The Provider | ALLISON |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3525 OLENTANGY RIVER ROAD |
| Street Address 2 Of The Provider | STE. 4330 |
| City Of The Provider | COLUMBUS |
| Zip Code Of The Provider | 43214 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 28 |
| Number Of Services | 1163 |
| Number Of Medicare Beneficiaries | 634 |
| Total Submitted Charge Amount | 213465.15 |
| Total Medicare Allowed Amount | 124335.56 |
| Total Medicare Payment Amount | 95533.38 |
| Total Medicare Standardized Payment Amount | 97798.05 |
| Drug Suppress Indicator | * |
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| Number Of Medicare Beneficiaries With Drug Services | |
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| Medical SuppressIndicator | # |
| Number Of HCPCS Associated With MedicalServices | |
| Number Of Medical Services | |
| Number Of Medicare Beneficiaries With Medical Services | |
| Total Medical Submitted Charge Amount | |
| Total Medical Medicare Allowed Amount | |
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| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 126 |
| Number Of Beneficiaries Age 65 to 74 | 169 |
| Number Of Beneficiaries Age 75 to 84 | 182 |
| Number Of Beneficiaries Age Greater 84 | 157 |
| Number Of Female Beneficiaries | 371 |
| Number Of Male Beneficiaries | 263 |
| Number Of Non Hispanic White Beneficiaries | 540 |
| Number Of Black or African American Beneficiaries | 80 |
| 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 | 398 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 236 |
| Percent Of With Atrial Fibrillation | 28 |
| Percent Of With Alzheimers Disease or Dementia | 29 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 50 |
| Percent Of With Chronic Kidney Disease | 55 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 32 |
| Percent Of With Depression | 46 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 56 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 12 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 2.4071 |