| National Provider Identifier [NPI]: | 1669406054 |
| Last Name Of The Provider | GUMM |
| First Name Of The Provider | DARREL |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5405 N KNOXVILLE AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | PEORIA |
| Zip Code Of The Provider | 61614 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 73 |
| Number Of Services | 5511 |
| Number Of Medicare Beneficiaries | 3135 |
| Total Submitted Charge Amount | 991195 |
| Total Medicare Allowed Amount | 313328.68 |
| Total Medicare Payment Amount | 227056.6 |
| Total Medicare Standardized Payment Amount | 231880.28 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 13 |
| Number Of Medicare Beneficiaries With Drug Services | 13 |
| Total Drug Submitted ChargeAmount | 563 |
| Total Drug Medicare AllowedAmount | 413.35 |
| Total Drug Medicare PaymentAmount | 405.07 |
| Total Drug Medicare Standardized Payment Amount | 405.07 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 71 |
| Number Of Medical Services | 5498 |
| Number Of Medicare Beneficiaries With Medical Services | 3135 |
| Total Medical Submitted Charge Amount | 990632 |
| Total Medical Medicare Allowed Amount | 312915.33 |
| Total Medical Medicare Payment Amount | 226651.53 |
| Total Medical Medicare Standardized Payment Amount | 231475.21 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 364 |
| Number Of Beneficiaries Age 65 to 74 | 1201 |
| Number Of Beneficiaries Age 75 to 84 | 1091 |
| Number Of Beneficiaries Age Greater 84 | 479 |
| Number Of Female Beneficiaries | 1531 |
| Number Of Male Beneficiaries | 1604 |
| Number Of Non Hispanic White Beneficiaries | 2902 |
| Number Of Black or African American Beneficiaries | 162 |
| 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 | 35 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2566 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 569 |
| Percent Of With Atrial Fibrillation | 26 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 35 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 60 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.6158 |