| National Provider Identifier [NPI]: | 1447256482 |
| Last Name Of The Provider | KEIGHTLEY |
| First Name Of The Provider | GERALD |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7605 FOREST AVE |
| Street Address 2 Of The Provider | STE 109 |
| City Of The Provider | RICHMOND |
| Zip Code Of The Provider | 232294938 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nephrology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 36 |
| Number Of Services | 30572 |
| Number Of Medicare Beneficiaries | 804 |
| Total Submitted Charge Amount | 888186.5 |
| Total Medicare Allowed Amount | 521004.25 |
| Total Medicare Payment Amount | 386184.91 |
| Total Medicare Standardized Payment Amount | 392566.67 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 26626 |
| Number Of Medicare Beneficiaries With Drug Services | 68 |
| Total Drug Submitted ChargeAmount | 134732.5 |
| Total Drug Medicare AllowedAmount | 68793.15 |
| Total Drug Medicare PaymentAmount | 48864.66 |
| Total Drug Medicare Standardized Payment Amount | 48864.66 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 33 |
| Number Of Medical Services | 3946 |
| Number Of Medicare Beneficiaries With Medical Services | 804 |
| Total Medical Submitted Charge Amount | 753454 |
| Total Medical Medicare Allowed Amount | 452211.1 |
| Total Medical Medicare Payment Amount | 337320.25 |
| Total Medical Medicare Standardized Payment Amount | 343702.01 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 120 |
| Number Of Beneficiaries Age 65 to 74 | 267 |
| Number Of Beneficiaries Age 75 to 84 | 278 |
| Number Of Beneficiaries Age Greater 84 | 139 |
| Number Of Female Beneficiaries | 394 |
| Number Of Male Beneficiaries | 410 |
| Number Of Non Hispanic White Beneficiaries | 493 |
| Number Of Black or African American Beneficiaries | 280 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 14 |
| Number Of Beneficiaries With Medicare Only Entitlement | 671 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 133 |
| Percent Of With Atrial Fibrillation | 23 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 46 |
| Percent Of With Chronic Kidney Disease | 75 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 58 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 55 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 3.3563 |