| National Provider Identifier [NPI]: | 1205888765 |
| Last Name Of The Provider | ELLER |
| First Name Of The Provider | KAREN |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 41A MARSHELLEN DR |
| Street Address 2 Of The Provider | PALMETTO PAIN PA |
| City Of The Provider | BEAUFORT |
| Zip Code Of The Provider | 299026900 |
| State Code Of The Provider | SC |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Interventional Pain Management |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 50 |
| Number Of Services | 9990 |
| Number Of Medicare Beneficiaries | 500 |
| Total Submitted Charge Amount | 877458.93 |
| Total Medicare Allowed Amount | 399518.48 |
| Total Medicare Payment Amount | 303342.43 |
| Total Medicare Standardized Payment Amount | 303391.43 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 6322 |
| Number Of Medicare Beneficiaries With Drug Services | 309 |
| Total Drug Submitted ChargeAmount | 39455.5 |
| Total Drug Medicare AllowedAmount | 21008.01 |
| Total Drug Medicare PaymentAmount | 15579.24 |
| Total Drug Medicare Standardized Payment Amount | 15579.24 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 43 |
| Number Of Medical Services | 3668 |
| Number Of Medicare Beneficiaries With Medical Services | 500 |
| Total Medical Submitted Charge Amount | 838003.43 |
| Total Medical Medicare Allowed Amount | 378510.47 |
| Total Medical Medicare Payment Amount | 287763.19 |
| Total Medical Medicare Standardized Payment Amount | 287812.19 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 89 |
| Number Of Beneficiaries Age 65 to 74 | 215 |
| Number Of Beneficiaries Age 75 to 84 | 143 |
| Number Of Beneficiaries Age Greater 84 | 53 |
| Number Of Female Beneficiaries | 322 |
| Number Of Male Beneficiaries | 178 |
| Number Of Non Hispanic White Beneficiaries | 425 |
| 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 | 462 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 38 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.2624 |