| National Provider Identifier [NPI]: | 1912938754 |
| Last Name Of The Provider | GUILLORY |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3209 N 4TH ST |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | LONGVIEW |
| Zip Code Of The Provider | 756055145 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 44 |
| Number Of Services | 3475 |
| Number Of Medicare Beneficiaries | 1642 |
| Total Submitted Charge Amount | 472689.66 |
| Total Medicare Allowed Amount | 448673.81 |
| Total Medicare Payment Amount | 315225.64 |
| Total Medicare Standardized Payment Amount | 338323.12 |
| 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 | 44 |
| Number Of Medical Services | 3475 |
| Number Of Medicare Beneficiaries With Medical Services | 1642 |
| Total Medical Submitted Charge Amount | 472689.66 |
| Total Medical Medicare Allowed Amount | 448673.81 |
| Total Medical Medicare Payment Amount | 315225.64 |
| Total Medical Medicare Standardized Payment Amount | 338323.12 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 48 |
| Number Of Beneficiaries Age 65 to 74 | 578 |
| Number Of Beneficiaries Age 75 to 84 | 687 |
| Number Of Beneficiaries Age Greater 84 | 329 |
| Number Of Female Beneficiaries | 1014 |
| Number Of Male Beneficiaries | 628 |
| Number Of Non Hispanic White Beneficiaries | 1533 |
| Number Of Black or African American Beneficiaries | 83 |
| 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 | 1538 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 104 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.0763 |