| National Provider Identifier [NPI]: | 1629376611 |
| Last Name Of The Provider | MCMAHON |
| First Name Of The Provider | KELLYN |
| Middle Initial Of The Provider | V |
| Credentials Of The Provider | CRNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 817 PRINCETON AVE SW |
| Street Address 2 Of The Provider | SUITE 206 |
| City Of The Provider | BIRMINGHAM |
| Zip Code Of The Provider | 352111333 |
| State Code Of The Provider | AL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 19 |
| Number Of Services | 3118 |
| Number Of Medicare Beneficiaries | 699 |
| Total Submitted Charge Amount | 122285.75 |
| Total Medicare Allowed Amount | 78587.87 |
| Total Medicare Payment Amount | 57262.67 |
| Total Medicare Standardized Payment Amount | 72610.31 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 1903 |
| Number Of Medicare Beneficiaries With Drug Services | 23 |
| Total Drug Submitted ChargeAmount | 14500 |
| Total Drug Medicare AllowedAmount | 7215.98 |
| Total Drug Medicare PaymentAmount | 5694.61 |
| Total Drug Medicare Standardized Payment Amount | 5694.61 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 15 |
| Number Of Medical Services | 1215 |
| Number Of Medicare Beneficiaries With Medical Services | 699 |
| Total Medical Submitted Charge Amount | 107785.75 |
| Total Medical Medicare Allowed Amount | 71371.89 |
| Total Medical Medicare Payment Amount | 51568.06 |
| Total Medical Medicare Standardized Payment Amount | 66915.7 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 109 |
| Number Of Beneficiaries Age 65 to 74 | 282 |
| Number Of Beneficiaries Age 75 to 84 | 237 |
| Number Of Beneficiaries Age Greater 84 | 71 |
| Number Of Female Beneficiaries | 354 |
| Number Of Male Beneficiaries | 345 |
| Number Of Non Hispanic White Beneficiaries | 478 |
| Number Of Black or African American Beneficiaries | 209 |
| 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 | 617 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 82 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 41 |
| Percent Of With Chronic Kidney Disease | 75 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 61 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 56 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.9889 |