National Provider Identifier [NPI]: |
1336251636 |
Last Name Of The Provider |
GILL |
First Name Of The Provider |
MARLIN |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2422 DANVILLE RD SW |
Street Address 2 Of The Provider |
SUITE E |
City Of The Provider |
DECATUR |
Zip Code Of The Provider |
356034220 |
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 |
94 |
Number Of Services |
3914 |
Number Of Medicare Beneficiaries |
398 |
Total Submitted Charge Amount |
281409 |
Total Medicare Allowed Amount |
163546.63 |
Total Medicare Payment Amount |
109770.33 |
Total Medicare Standardized Payment Amount |
121401.34 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
10 |
Number Of Drug Services |
1086 |
Number Of Medicare Beneficiaries With Drug Services |
117 |
Total Drug Submitted ChargeAmount |
23201 |
Total Drug Medicare AllowedAmount |
15552.11 |
Total Drug Medicare PaymentAmount |
12445.2 |
Total Drug Medicare Standardized Payment Amount |
12445.2 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
84 |
Number Of Medical Services |
2828 |
Number Of Medicare Beneficiaries With Medical Services |
397 |
Total Medical Submitted Charge Amount |
258208 |
Total Medical Medicare Allowed Amount |
147994.52 |
Total Medical Medicare Payment Amount |
97325.13 |
Total Medical Medicare Standardized Payment Amount |
108956.14 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
51 |
Number Of Beneficiaries Age 65 to 74 |
241 |
Number Of Beneficiaries Age 75 to 84 |
78 |
Number Of Beneficiaries Age Greater 84 |
28 |
Number Of Female Beneficiaries |
209 |
Number Of Male Beneficiaries |
189 |
Number Of Non Hispanic White Beneficiaries |
356 |
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 |
366 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
32 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
3 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
10 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
70 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
27 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
26 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8679 |