National Provider Identifier [NPI]: |
1053300244 |
Last Name Of The Provider |
MCGILL |
First Name Of The Provider |
LORRIE |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1502 S WASHINGTON ST |
Street Address 2 Of The Provider |
STE 201 |
City Of The Provider |
PAPILLION |
Zip Code Of The Provider |
680463136 |
State Code Of The Provider |
NE |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
65 |
Number Of Services |
1859 |
Number Of Medicare Beneficiaries |
194 |
Total Submitted Charge Amount |
172265.5 |
Total Medicare Allowed Amount |
88029.26 |
Total Medicare Payment Amount |
60929.91 |
Total Medicare Standardized Payment Amount |
68311.02 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
10 |
Number Of Drug Services |
422 |
Number Of Medicare Beneficiaries With Drug Services |
86 |
Total Drug Submitted ChargeAmount |
8016.5 |
Total Drug Medicare AllowedAmount |
5055.21 |
Total Drug Medicare PaymentAmount |
4272.43 |
Total Drug Medicare Standardized Payment Amount |
4272.43 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
55 |
Number Of Medical Services |
1437 |
Number Of Medicare Beneficiaries With Medical Services |
194 |
Total Medical Submitted Charge Amount |
164249 |
Total Medical Medicare Allowed Amount |
82974.05 |
Total Medical Medicare Payment Amount |
56657.48 |
Total Medical Medicare Standardized Payment Amount |
64038.59 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
34 |
Number Of Beneficiaries Age 65 to 74 |
100 |
Number Of Beneficiaries Age 75 to 84 |
40 |
Number Of Beneficiaries Age Greater 84 |
20 |
Number Of Female Beneficiaries |
141 |
Number Of Male Beneficiaries |
53 |
Number Of Non Hispanic White Beneficiaries |
182 |
Number Of Black or African American Beneficiaries |
|
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 |
174 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
20 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
7 |
Percent Of With Chronic Kidney Disease |
10 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
36 |
Percent Of With Hypertension |
42 |
Percent Of With Ischemic Heart Disease |
21 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8418 |