| National Provider Identifier [NPI]: | 1922089556 |
| Last Name Of The Provider | KELLY |
| First Name Of The Provider | DANIEL |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 701 RANDOLPH ST STE 120 |
| Street Address 2 Of The Provider | |
| City Of The Provider | RADFORD |
| Zip Code Of The Provider | 241413047 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 66 |
| Number Of Services | 5815 |
| Number Of Medicare Beneficiaries | 660 |
| Total Submitted Charge Amount | 349121 |
| Total Medicare Allowed Amount | 239661.84 |
| Total Medicare Payment Amount | 183893.49 |
| Total Medicare Standardized Payment Amount | 190135.5 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 15 |
| Number Of Drug Services | 1804 |
| Number Of Medicare Beneficiaries With Drug Services | 377 |
| Total Drug Submitted ChargeAmount | 50149 |
| Total Drug Medicare AllowedAmount | 27220.05 |
| Total Drug Medicare PaymentAmount | 23805.32 |
| Total Drug Medicare Standardized Payment Amount | 23805.32 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 51 |
| Number Of Medical Services | 4011 |
| Number Of Medicare Beneficiaries With Medical Services | 646 |
| Total Medical Submitted Charge Amount | 298972 |
| Total Medical Medicare Allowed Amount | 212441.79 |
| Total Medical Medicare Payment Amount | 160088.17 |
| Total Medical Medicare Standardized Payment Amount | 166330.18 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 111 |
| Number Of Beneficiaries Age 65 to 74 | 340 |
| Number Of Beneficiaries Age 75 to 84 | 155 |
| Number Of Beneficiaries Age Greater 84 | 54 |
| Number Of Female Beneficiaries | 376 |
| Number Of Male Beneficiaries | 284 |
| Number Of Non Hispanic White Beneficiaries | 631 |
| Number Of Black or African American Beneficiaries | |
| 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 | |
| Number Of Beneficiaries With Medicare Only Entitlement | 572 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 88 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 53 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.97 |