| National Provider Identifier [NPI]: | 1689789950 |
| Last Name Of The Provider | KELLAM |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4708 ALLIANCE BLVD STE 300 |
| Street Address 2 Of The Provider | BAYLOR MEDICAL PLAZA 1 |
| City Of The Provider | PLANO |
| Zip Code Of The Provider | 750935339 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Neurology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 67 |
| Number Of Services | 2153 |
| Number Of Medicare Beneficiaries | 606 |
| Total Submitted Charge Amount | 441421 |
| Total Medicare Allowed Amount | 196424.55 |
| Total Medicare Payment Amount | 143985.29 |
| Total Medicare Standardized Payment Amount | 154927.04 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 370 |
| Number Of Medicare Beneficiaries With Drug Services | 17 |
| Total Drug Submitted ChargeAmount | 2730 |
| Total Drug Medicare AllowedAmount | 623.61 |
| Total Drug Medicare PaymentAmount | 454.04 |
| Total Drug Medicare Standardized Payment Amount | 454.04 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 65 |
| Number Of Medical Services | 1783 |
| Number Of Medicare Beneficiaries With Medical Services | 606 |
| Total Medical Submitted Charge Amount | 438691 |
| Total Medical Medicare Allowed Amount | 195800.94 |
| Total Medical Medicare Payment Amount | 143531.25 |
| Total Medical Medicare Standardized Payment Amount | 154473 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 52 |
| Number Of Beneficiaries Age 65 to 74 | 249 |
| Number Of Beneficiaries Age 75 to 84 | 214 |
| Number Of Beneficiaries Age Greater 84 | 91 |
| Number Of Female Beneficiaries | 350 |
| Number Of Male Beneficiaries | 256 |
| Number Of Non Hispanic White Beneficiaries | 547 |
| Number Of Black or African American Beneficiaries | 23 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 20 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 577 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 29 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 26 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 19 |
| Average HCC Risk Score Of Beneficiaries | 1.4353 |