| National Provider Identifier [NPI]: | 1649222142 |
| Last Name Of The Provider | LILLIS |
| First Name Of The Provider | TERENCE |
| Middle Initial Of The Provider | O |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2240 E 38TH ST |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | ERIE |
| Zip Code Of The Provider | 165103688 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 44 |
| Number Of Services | 473 |
| Number Of Medicare Beneficiaries | 132 |
| Total Submitted Charge Amount | 59057 |
| Total Medicare Allowed Amount | 39944.47 |
| Total Medicare Payment Amount | 28858.53 |
| Total Medicare Standardized Payment Amount | 30283.48 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 12 |
| Number Of Drug Services | 49 |
| Number Of Medicare Beneficiaries With Drug Services | 38 |
| Total Drug Submitted ChargeAmount | 1679 |
| Total Drug Medicare AllowedAmount | 1251.24 |
| Total Drug Medicare PaymentAmount | 1210.14 |
| Total Drug Medicare Standardized Payment Amount | 1210.14 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 32 |
| Number Of Medical Services | 424 |
| Number Of Medicare Beneficiaries With Medical Services | 132 |
| Total Medical Submitted Charge Amount | 57378 |
| Total Medical Medicare Allowed Amount | 38693.23 |
| Total Medical Medicare Payment Amount | 27648.39 |
| Total Medical Medicare Standardized Payment Amount | 29073.34 |
| Average Age Of Beneficiaries | 66 |
| Number Of Beneficiaries Age Less65 | 49 |
| Number Of Beneficiaries Age 65 to 74 | 49 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 70 |
| Number Of Male Beneficiaries | 62 |
| Number Of Non Hispanic White Beneficiaries | 112 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 88 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 44 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 55 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 24 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1828 |