National Provider Identifier [NPI]: |
1750514261 |
Last Name Of The Provider |
GILL |
First Name Of The Provider |
KRISTI |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2940 N LITCHFIELD RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
GOODYEAR |
Zip Code Of The Provider |
853957830 |
State Code Of The Provider |
AZ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Neurology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
26 |
Number Of Services |
569 |
Number Of Medicare Beneficiaries |
296 |
Total Submitted Charge Amount |
173020 |
Total Medicare Allowed Amount |
69350.53 |
Total Medicare Payment Amount |
46642.06 |
Total Medicare Standardized Payment Amount |
47111.9 |
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 |
569 |
Number Of Medicare Beneficiaries With Medical Services |
296 |
Total Medical Submitted Charge Amount |
173020 |
Total Medical Medicare Allowed Amount |
69350.53 |
Total Medical Medicare Payment Amount |
46642.06 |
Total Medical Medicare Standardized Payment Amount |
47111.9 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
38 |
Number Of Beneficiaries Age 65 to 74 |
116 |
Number Of Beneficiaries Age 75 to 84 |
103 |
Number Of Beneficiaries Age Greater 84 |
39 |
Number Of Female Beneficiaries |
143 |
Number Of Male Beneficiaries |
153 |
Number Of Non Hispanic White Beneficiaries |
281 |
Number Of Black or African American Beneficiaries |
0 |
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 |
243 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
53 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
25 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
20 |
Percent Of With Chronic Kidney Disease |
28 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
24 |
Percent Of With Hyperlipidemia |
50 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
43 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
53 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
22 |
Average HCC Risk Score Of Beneficiaries |
1.4924 |