National Provider Identifier [NPI]: |
1285655795 |
Last Name Of The Provider |
GILLHAM |
First Name Of The Provider |
GREG |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
555 S 70TH ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
LINCOLN |
Zip Code Of The Provider |
685102462 |
State Code Of The Provider |
NE |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
26 |
Number Of Services |
1422 |
Number Of Medicare Beneficiaries |
590 |
Total Submitted Charge Amount |
231784 |
Total Medicare Allowed Amount |
118700 |
Total Medicare Payment Amount |
89642.52 |
Total Medicare Standardized Payment Amount |
95061.19 |
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 |
1422 |
Number Of Medicare Beneficiaries With Medical Services |
590 |
Total Medical Submitted Charge Amount |
231784 |
Total Medical Medicare Allowed Amount |
118700 |
Total Medical Medicare Payment Amount |
89642.52 |
Total Medical Medicare Standardized Payment Amount |
95061.19 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
73 |
Number Of Beneficiaries Age 65 to 74 |
171 |
Number Of Beneficiaries Age 75 to 84 |
184 |
Number Of Beneficiaries Age Greater 84 |
162 |
Number Of Female Beneficiaries |
336 |
Number Of Male Beneficiaries |
254 |
Number Of Non Hispanic White Beneficiaries |
563 |
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 |
458 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
132 |
Percent Of With Atrial Fibrillation |
30 |
Percent Of With Alzheimers Disease or Dementia |
25 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
19 |
Percent Of With Heart Failure |
39 |
Percent Of With Chronic Kidney Disease |
51 |
Percent Of With Chronic Obstructive Pulmonary Disease |
33 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
51 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
56 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
1.992 |