| National Provider Identifier [NPI]: | 1639138795 |
| Last Name Of The Provider | ELLIOTT |
| First Name Of The Provider | JEFFREY |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1901 MELBA DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | DOTHAN |
| Zip Code Of The Provider | 363013017 |
| State Code Of The Provider | AL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 102 |
| Number Of Services | 17213 |
| Number Of Medicare Beneficiaries | 2450 |
| Total Submitted Charge Amount | 968019 |
| Total Medicare Allowed Amount | 746608.83 |
| Total Medicare Payment Amount | 564470.51 |
| Total Medicare Standardized Payment Amount | 497127.85 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 12 |
| Number Of Drug Services | 3811 |
| Number Of Medicare Beneficiaries With Drug Services | 399 |
| Total Drug Submitted ChargeAmount | 87498 |
| Total Drug Medicare AllowedAmount | 38020.15 |
| Total Drug Medicare PaymentAmount | 30352.94 |
| Total Drug Medicare Standardized Payment Amount | 30352.94 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 90 |
| Number Of Medical Services | 13402 |
| Number Of Medicare Beneficiaries With Medical Services | 2438 |
| Total Medical Submitted Charge Amount | 880521 |
| Total Medical Medicare Allowed Amount | 708588.68 |
| Total Medical Medicare Payment Amount | 534117.57 |
| Total Medical Medicare Standardized Payment Amount | 466774.91 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 492 |
| Number Of Beneficiaries Age 65 to 74 | 915 |
| Number Of Beneficiaries Age 75 to 84 | 715 |
| Number Of Beneficiaries Age Greater 84 | 328 |
| Number Of Female Beneficiaries | 1394 |
| Number Of Male Beneficiaries | 1056 |
| Number Of Non Hispanic White Beneficiaries | 1941 |
| Number Of Black or African American Beneficiaries | 471 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 17 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1723 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 727 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 23 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 46 |
| Percent Of With Hyperlipidemia | 74 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 55 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 56 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 17 |
| Average HCC Risk Score Of Beneficiaries | 1.6759 |