| National Provider Identifier [NPI]: | 1740229038 |
| Last Name Of The Provider | KELLEY |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 191 DEEP SOUTH FARM RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | BLAIRSVILLE |
| Zip Code Of The Provider | 305122220 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 49 |
| Number Of Services | 6716 |
| Number Of Medicare Beneficiaries | 1429 |
| Total Submitted Charge Amount | 1715915.1 |
| Total Medicare Allowed Amount | 503478.71 |
| Total Medicare Payment Amount | 375687.71 |
| Total Medicare Standardized Payment Amount | 399328.99 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 530 |
| Number Of Medicare Beneficiaries With Drug Services | 128 |
| Total Drug Submitted ChargeAmount | 63765 |
| Total Drug Medicare AllowedAmount | 24556.62 |
| Total Drug Medicare PaymentAmount | 18903.95 |
| Total Drug Medicare Standardized Payment Amount | 18903.95 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 45 |
| Number Of Medical Services | 6186 |
| Number Of Medicare Beneficiaries With Medical Services | 1429 |
| Total Medical Submitted Charge Amount | 1652150.1 |
| Total Medical Medicare Allowed Amount | 478922.09 |
| Total Medical Medicare Payment Amount | 356783.76 |
| Total Medical Medicare Standardized Payment Amount | 380425.04 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 96 |
| Number Of Beneficiaries Age 65 to 74 | 649 |
| Number Of Beneficiaries Age 75 to 84 | 500 |
| Number Of Beneficiaries Age Greater 84 | 184 |
| Number Of Female Beneficiaries | 676 |
| Number Of Male Beneficiaries | 753 |
| Number Of Non Hispanic White Beneficiaries | 1396 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 14 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1287 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 142 |
| Percent Of With Atrial Fibrillation | 24 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 54 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.2285 |