| National Provider Identifier [NPI]: | 1720056823 |
| Last Name Of The Provider | ELLIS |
| First Name Of The Provider | ROBERT |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3850 S NATIONAL AVE |
| Street Address 2 Of The Provider | SUITE 600 |
| City Of The Provider | SPRINGFIELD |
| Zip Code Of The Provider | 658075287 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 119 |
| Number Of Services | 133624 |
| Number Of Medicare Beneficiaries | 794 |
| Total Submitted Charge Amount | 4560884.8 |
| Total Medicare Allowed Amount | 2279952.74 |
| Total Medicare Payment Amount | 1777856.1 |
| Total Medicare Standardized Payment Amount | 1800107.33 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 68 |
| Number Of Drug Services | 120572 |
| Number Of Medicare Beneficiaries With Drug Services | 195 |
| Total Drug Submitted ChargeAmount | 3633977.8 |
| Total Drug Medicare AllowedAmount | 1843985.12 |
| Total Drug Medicare PaymentAmount | 1442110.38 |
| Total Drug Medicare Standardized Payment Amount | 1442110.38 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 51 |
| Number Of Medical Services | 13052 |
| Number Of Medicare Beneficiaries With Medical Services | 794 |
| Total Medical Submitted Charge Amount | 926907 |
| Total Medical Medicare Allowed Amount | 435967.62 |
| Total Medical Medicare Payment Amount | 335745.72 |
| Total Medical Medicare Standardized Payment Amount | 357996.95 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 104 |
| Number Of Beneficiaries Age 65 to 74 | 361 |
| Number Of Beneficiaries Age 75 to 84 | 249 |
| Number Of Beneficiaries Age Greater 84 | 80 |
| Number Of Female Beneficiaries | 413 |
| Number Of Male Beneficiaries | 381 |
| Number Of Non Hispanic White Beneficiaries | 774 |
| 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 | 699 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 95 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 46 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 42 |
| Percent Of With Hypertension | 62 |
| Percent Of With Ischemic Heart Disease | 28 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.806 |