| National Provider Identifier [NPI]: | 1689655755 |
| Last Name Of The Provider | KELLAWAY |
| First Name Of The Provider | JUDIANNE |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M. D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6400 FANNIN ST |
| Street Address 2 Of The Provider | 18TH FLOOR |
| City Of The Provider | HOUSTON |
| Zip Code Of The Provider | 770301511 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 32 |
| Number Of Services | 856 |
| Number Of Medicare Beneficiaries | 319 |
| Total Submitted Charge Amount | 176158 |
| Total Medicare Allowed Amount | 87669.68 |
| Total Medicare Payment Amount | 62065.74 |
| Total Medicare Standardized Payment Amount | 62053.41 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 27 |
| Number Of Medicare Beneficiaries With Drug Services | 16 |
| Total Drug Submitted ChargeAmount | 2700 |
| Total Drug Medicare AllowedAmount | 1780.08 |
| Total Drug Medicare PaymentAmount | 1344.08 |
| Total Drug Medicare Standardized Payment Amount | 1344.08 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 31 |
| Number Of Medical Services | 829 |
| Number Of Medicare Beneficiaries With Medical Services | 319 |
| Total Medical Submitted Charge Amount | 173458 |
| Total Medical Medicare Allowed Amount | 85889.6 |
| Total Medical Medicare Payment Amount | 60721.66 |
| Total Medical Medicare Standardized Payment Amount | 60709.33 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 68 |
| Number Of Beneficiaries Age 65 to 74 | 139 |
| Number Of Beneficiaries Age 75 to 84 | 86 |
| Number Of Beneficiaries Age Greater 84 | 26 |
| Number Of Female Beneficiaries | 197 |
| Number Of Male Beneficiaries | 122 |
| Number Of Non Hispanic White Beneficiaries | 167 |
| Number Of Black or African American Beneficiaries | 68 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 67 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 239 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 80 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 51 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.9835 |