| National Provider Identifier [NPI]: | 1538266408 |
| Last Name Of The Provider | KELL |
| First Name Of The Provider | JONATHAN |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 222 15TH AVE SE |
| Street Address 2 Of The Provider | |
| City Of The Provider | PUYALLUP |
| Zip Code Of The Provider | 983723754 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 178 |
| Number Of Services | 16409 |
| Number Of Medicare Beneficiaries | 3395 |
| Total Submitted Charge Amount | 934365 |
| Total Medicare Allowed Amount | 262344.78 |
| Total Medicare Payment Amount | 199366.96 |
| Total Medicare Standardized Payment Amount | 202272.24 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 11539 |
| Number Of Medicare Beneficiaries With Drug Services | 133 |
| Total Drug Submitted ChargeAmount | 23078 |
| Total Drug Medicare AllowedAmount | 3443.72 |
| Total Drug Medicare PaymentAmount | 2699.91 |
| Total Drug Medicare Standardized Payment Amount | 2699.91 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 176 |
| Number Of Medical Services | 4870 |
| Number Of Medicare Beneficiaries With Medical Services | 3394 |
| Total Medical Submitted Charge Amount | 911287 |
| Total Medical Medicare Allowed Amount | 258901.06 |
| Total Medical Medicare Payment Amount | 196667.05 |
| Total Medical Medicare Standardized Payment Amount | 199572.33 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 528 |
| Number Of Beneficiaries Age 65 to 74 | 1262 |
| Number Of Beneficiaries Age 75 to 84 | 1017 |
| Number Of Beneficiaries Age Greater 84 | 588 |
| Number Of Female Beneficiaries | 2030 |
| Number Of Male Beneficiaries | 1365 |
| Number Of Non Hispanic White Beneficiaries | 3066 |
| Number Of Black or African American Beneficiaries | 102 |
| Number Of AsianPacific Islander Beneficiaries | 71 |
| Number Of Hispanic Beneficiaries | 75 |
| Number Of American Indian Alaska Native Beneficiaries | 30 |
| Number Of Beneficiaries With Race Not Else where Classified | 51 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2743 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 652 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.6015 |