National Provider Identifier [NPI]: |
1689620189 |
Last Name Of The Provider |
GILL |
First Name Of The Provider |
NEELU |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
675 TOWER AVE |
Street Address 2 Of The Provider |
SUITE 301 |
City Of The Provider |
HARTFORD |
Zip Code Of The Provider |
061121273 |
State Code Of The Provider |
CT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Psychiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
11 |
Number Of Services |
463 |
Number Of Medicare Beneficiaries |
116 |
Total Submitted Charge Amount |
50561 |
Total Medicare Allowed Amount |
32044.13 |
Total Medicare Payment Amount |
21038.74 |
Total Medicare Standardized Payment Amount |
22165.97 |
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 |
11 |
Number Of Medical Services |
463 |
Number Of Medicare Beneficiaries With Medical Services |
116 |
Total Medical Submitted Charge Amount |
50561 |
Total Medical Medicare Allowed Amount |
32044.13 |
Total Medical Medicare Payment Amount |
21038.74 |
Total Medical Medicare Standardized Payment Amount |
22165.97 |
Average Age Of Beneficiaries |
55 |
Number Of Beneficiaries Age Less65 |
81 |
Number Of Beneficiaries Age 65 to 74 |
19 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
60 |
Number Of Male Beneficiaries |
56 |
Number Of Non Hispanic White Beneficiaries |
95 |
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 |
24 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
92 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
9 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
61 |
Percent Of With Diabetes |
22 |
Percent Of With Hyperlipidemia |
40 |
Percent Of With Hypertension |
42 |
Percent Of With Ischemic Heart Disease |
14 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
15 |
Percent Of With Schizophrenia Other PsychoticDisorders |
53 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.2473 |