| National Provider Identifier [NPI]: | 1962445346 |
| Last Name Of The Provider | KELLER |
| First Name Of The Provider | ROBERT |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 301 CLIFFORD CENTER DR |
| Street Address 2 Of The Provider | SUITE 115 |
| City Of The Provider | FORT WORTH |
| Zip Code Of The Provider | 761084443 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 102 |
| Number Of Services | 7313 |
| Number Of Medicare Beneficiaries | 895 |
| Total Submitted Charge Amount | 807949 |
| Total Medicare Allowed Amount | 373224.35 |
| Total Medicare Payment Amount | 264391.09 |
| Total Medicare Standardized Payment Amount | 271441.45 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 2253 |
| Number Of Medicare Beneficiaries With Drug Services | 254 |
| Total Drug Submitted ChargeAmount | 99826 |
| Total Drug Medicare AllowedAmount | 33880.73 |
| Total Drug Medicare PaymentAmount | 27445.88 |
| Total Drug Medicare Standardized Payment Amount | 27445.88 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 91 |
| Number Of Medical Services | 5060 |
| Number Of Medicare Beneficiaries With Medical Services | 895 |
| Total Medical Submitted Charge Amount | 708123 |
| Total Medical Medicare Allowed Amount | 339343.62 |
| Total Medical Medicare Payment Amount | 236945.21 |
| Total Medical Medicare Standardized Payment Amount | 243995.57 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 116 |
| Number Of Beneficiaries Age 65 to 74 | 280 |
| Number Of Beneficiaries Age 75 to 84 | 334 |
| Number Of Beneficiaries Age Greater 84 | 165 |
| Number Of Female Beneficiaries | 525 |
| Number Of Male Beneficiaries | 370 |
| Number Of Non Hispanic White Beneficiaries | 783 |
| Number Of Black or African American Beneficiaries | 55 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 42 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 760 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 135 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 24 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 56 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.4931 |