| National Provider Identifier [NPI]: | 1093702326 |
| Last Name Of The Provider | GALLAGHER |
| First Name Of The Provider | EILEEN |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | DO |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4208 B EVA RD |
| Street Address 2 Of The Provider | EVA HEALTH CENTER |
| City Of The Provider | EVA |
| Zip Code Of The Provider | 35621 |
| State Code Of The Provider | AL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 80 |
| Number Of Services | 1287 |
| Number Of Medicare Beneficiaries | 178 |
| Total Submitted Charge Amount | 62175.06 |
| Total Medicare Allowed Amount | 37542.85 |
| Total Medicare Payment Amount | 27787.06 |
| Total Medicare Standardized Payment Amount | 29076.94 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 14 |
| Number Of Drug Services | 432 |
| Number Of Medicare Beneficiaries With Drug Services | 91 |
| Total Drug Submitted ChargeAmount | 5534 |
| Total Drug Medicare AllowedAmount | 2052.13 |
| Total Drug Medicare PaymentAmount | 1584.61 |
| Total Drug Medicare Standardized Payment Amount | 1584.61 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 66 |
| Number Of Medical Services | 855 |
| Number Of Medicare Beneficiaries With Medical Services | 178 |
| Total Medical Submitted Charge Amount | 56641.06 |
| Total Medical Medicare Allowed Amount | 35490.72 |
| Total Medical Medicare Payment Amount | 26202.45 |
| Total Medical Medicare Standardized Payment Amount | 27492.33 |
| Average Age Of Beneficiaries | 64 |
| Number Of Beneficiaries Age Less65 | 69 |
| Number Of Beneficiaries Age 65 to 74 | 62 |
| Number Of Beneficiaries Age 75 to 84 | 36 |
| Number Of Beneficiaries Age Greater 84 | 11 |
| Number Of Female Beneficiaries | 108 |
| Number Of Male Beneficiaries | 70 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| 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 | |
| Number Of Beneficiaries With Medicare Only Entitlement | 116 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 62 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1332 |