| National Provider Identifier [NPI]: | 1154409282 |
| Last Name Of The Provider | KELLER |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 203 EAST MAIN ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | RICHMOND |
| Zip Code Of The Provider | 47374 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 31 |
| Number Of Services | 2007 |
| Number Of Medicare Beneficiaries | 965 |
| Total Submitted Charge Amount | 51552 |
| Total Medicare Allowed Amount | 33661.09 |
| Total Medicare Payment Amount | 32562.72 |
| Total Medicare Standardized Payment Amount | 34302.43 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 896 |
| Number Of Medicare Beneficiaries With Drug Services | 858 |
| Total Drug Submitted ChargeAmount | 23371 |
| Total Drug Medicare AllowedAmount | 10737.93 |
| Total Drug Medicare PaymentAmount | 10524.22 |
| Total Drug Medicare Standardized Payment Amount | 10524.22 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 26 |
| Number Of Medical Services | 1111 |
| Number Of Medicare Beneficiaries With Medical Services | 965 |
| Total Medical Submitted Charge Amount | 28181 |
| Total Medical Medicare Allowed Amount | 22923.16 |
| Total Medical Medicare Payment Amount | 22038.5 |
| Total Medical Medicare Standardized Payment Amount | 23778.21 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 189 |
| Number Of Beneficiaries Age 65 to 74 | 425 |
| Number Of Beneficiaries Age 75 to 84 | 255 |
| Number Of Beneficiaries Age Greater 84 | 96 |
| Number Of Female Beneficiaries | 566 |
| Number Of Male Beneficiaries | 399 |
| Number Of Non Hispanic White Beneficiaries | 906 |
| Number Of Black or African American Beneficiaries | 41 |
| 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 | 721 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 244 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 6 |
| 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 | 12 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 59 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 2 |
| Average HCC Risk Score Of Beneficiaries | 0.9284 |