| National Provider Identifier [NPI]: | 1043202856 |
| Last Name Of The Provider | TERRELL |
| First Name Of The Provider | MERVIN |
| 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 | 4747 DUSTY LAKE DR |
| Street Address 2 Of The Provider | SUITE 101 |
| City Of The Provider | PINE BLUFF |
| Zip Code Of The Provider | 716038742 |
| State Code Of The Provider | AR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Geriatric Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 26 |
| Number Of Services | 3198 |
| Number Of Medicare Beneficiaries | 680 |
| Total Submitted Charge Amount | 378937 |
| Total Medicare Allowed Amount | 169433.73 |
| Total Medicare Payment Amount | 115006.9 |
| Total Medicare Standardized Payment Amount | 123852.55 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 26 |
| Number Of Medical Services | 3198 |
| Number Of Medicare Beneficiaries With Medical Services | 680 |
| Total Medical Submitted Charge Amount | 378937 |
| Total Medical Medicare Allowed Amount | 169433.73 |
| Total Medical Medicare Payment Amount | 115006.9 |
| Total Medical Medicare Standardized Payment Amount | 123852.55 |
| Average Age Of Beneficiaries | 82 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | |
| Number Of Beneficiaries Age 75 to 84 | 295 |
| Number Of Beneficiaries Age Greater 84 | 256 |
| Number Of Female Beneficiaries | 494 |
| Number Of Male Beneficiaries | 186 |
| Number Of Non Hispanic White Beneficiaries | 537 |
| 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 | 531 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 149 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 43 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 38 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.2923 |