| National Provider Identifier [NPI]: | 1467427641 |
| Last Name Of The Provider | GALLAGHER |
| First Name Of The Provider | THOMAS |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 908 N ELM ST |
| Street Address 2 Of The Provider | STE 301 |
| City Of The Provider | HINSDALE |
| Zip Code Of The Provider | 605213635 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 66 |
| Number Of Services | 5626 |
| Number Of Medicare Beneficiaries | 990 |
| Total Submitted Charge Amount | 637667 |
| Total Medicare Allowed Amount | 305597.45 |
| Total Medicare Payment Amount | 223541.42 |
| Total Medicare Standardized Payment Amount | 211836.75 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 582 |
| Number Of Medicare Beneficiaries With Drug Services | 372 |
| Total Drug Submitted ChargeAmount | 29031 |
| Total Drug Medicare AllowedAmount | 17044.23 |
| Total Drug Medicare PaymentAmount | 16260.87 |
| Total Drug Medicare Standardized Payment Amount | 16260.87 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 55 |
| Number Of Medical Services | 5044 |
| Number Of Medicare Beneficiaries With Medical Services | 990 |
| Total Medical Submitted Charge Amount | 608636 |
| Total Medical Medicare Allowed Amount | 288553.22 |
| Total Medical Medicare Payment Amount | 207280.55 |
| Total Medical Medicare Standardized Payment Amount | 195575.88 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 16 |
| Number Of Beneficiaries Age 65 to 74 | 425 |
| Number Of Beneficiaries Age 75 to 84 | 354 |
| Number Of Beneficiaries Age Greater 84 | 195 |
| Number Of Female Beneficiaries | 489 |
| Number Of Male Beneficiaries | 501 |
| Number Of Non Hispanic White Beneficiaries | 932 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 17 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 24 |
| Number Of Beneficiaries With Medicare Only Entitlement | 976 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 14 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.0308 |