| National Provider Identifier [NPI]: | 1942277827 |
| Last Name Of The Provider | GUILL |
| First Name Of The Provider | BRADLEY |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 8205 E 56TH ST |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | INDIANAPOLIS |
| Zip Code Of The Provider | 462161056 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 31 |
| Number Of Services | 2782 |
| Number Of Medicare Beneficiaries | 649 |
| Total Submitted Charge Amount | 232779 |
| Total Medicare Allowed Amount | 165042.38 |
| Total Medicare Payment Amount | 120147.11 |
| Total Medicare Standardized Payment Amount | 127783.22 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 117 |
| Number Of Medicare Beneficiaries With Drug Services | 96 |
| Total Drug Submitted ChargeAmount | 10976 |
| Total Drug Medicare AllowedAmount | 7090.59 |
| Total Drug Medicare PaymentAmount | 6735.34 |
| Total Drug Medicare Standardized Payment Amount | 6735.34 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 25 |
| Number Of Medical Services | 2665 |
| Number Of Medicare Beneficiaries With Medical Services | 649 |
| Total Medical Submitted Charge Amount | 221803 |
| Total Medical Medicare Allowed Amount | 157951.79 |
| Total Medical Medicare Payment Amount | 113411.77 |
| Total Medical Medicare Standardized Payment Amount | 121047.88 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 117 |
| Number Of Beneficiaries Age 65 to 74 | 281 |
| Number Of Beneficiaries Age 75 to 84 | 176 |
| Number Of Beneficiaries Age Greater 84 | 75 |
| Number Of Female Beneficiaries | 323 |
| Number Of Male Beneficiaries | 326 |
| Number Of Non Hispanic White Beneficiaries | 534 |
| Number Of Black or African American Beneficiaries | 100 |
| 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 | 517 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 132 |
| Percent Of With Atrial Fibrillation | 26 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 47 |
| Percent Of With Chronic Kidney Disease | 46 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 75 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 65 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 2.1879 |