| National Provider Identifier [NPI]: | 1427004704 |
| Last Name Of The Provider | KELLEY |
| First Name Of The Provider | MARK |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1300 SUNSET DR |
| Street Address 2 Of The Provider | SUITE A |
| City Of The Provider | GRENADA |
| Zip Code Of The Provider | 389014086 |
| State Code Of The Provider | MS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 94 |
| Number Of Services | 14552 |
| Number Of Medicare Beneficiaries | 2159 |
| Total Submitted Charge Amount | 867770.23 |
| Total Medicare Allowed Amount | 741326.52 |
| Total Medicare Payment Amount | 539842.23 |
| Total Medicare Standardized Payment Amount | 607319.92 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 2473 |
| Number Of Medicare Beneficiaries With Drug Services | 483 |
| Total Drug Submitted ChargeAmount | 8833.25 |
| Total Drug Medicare AllowedAmount | 5551.05 |
| Total Drug Medicare PaymentAmount | 3987.55 |
| Total Drug Medicare Standardized Payment Amount | 3987.55 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 89 |
| Number Of Medical Services | 12079 |
| Number Of Medicare Beneficiaries With Medical Services | 2159 |
| Total Medical Submitted Charge Amount | 858936.98 |
| Total Medical Medicare Allowed Amount | 735775.47 |
| Total Medical Medicare Payment Amount | 535854.68 |
| Total Medical Medicare Standardized Payment Amount | 603332.37 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 209 |
| Number Of Beneficiaries Age 65 to 74 | 1001 |
| Number Of Beneficiaries Age 75 to 84 | 697 |
| Number Of Beneficiaries Age Greater 84 | 252 |
| Number Of Female Beneficiaries | 1056 |
| Number Of Male Beneficiaries | 1103 |
| Number Of Non Hispanic White Beneficiaries | 1955 |
| Number Of Black or African American Beneficiaries | 191 |
| 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 | 1836 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 323 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 3 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 11 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.9651 |