| National Provider Identifier [NPI]: | 1386630093 |
| Last Name Of The Provider | GILLEN |
| First Name Of The Provider | WILLIAM |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 11803 JEFFERSON AVE |
| Street Address 2 Of The Provider | SUITE 110 |
| City Of The Provider | NEWPORT NEWS |
| Zip Code Of The Provider | 236062565 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 49 |
| Number Of Services | 5853 |
| Number Of Medicare Beneficiaries | 2982 |
| Total Submitted Charge Amount | 471162 |
| Total Medicare Allowed Amount | 226738.1 |
| Total Medicare Payment Amount | 167581.06 |
| Total Medicare Standardized Payment Amount | 166898.93 |
| 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 | 49 |
| Number Of Medical Services | 5853 |
| Number Of Medicare Beneficiaries With Medical Services | 2982 |
| Total Medical Submitted Charge Amount | 471162 |
| Total Medical Medicare Allowed Amount | 226738.1 |
| Total Medical Medicare Payment Amount | 167581.06 |
| Total Medical Medicare Standardized Payment Amount | 166898.93 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 310 |
| Number Of Beneficiaries Age 65 to 74 | 1021 |
| Number Of Beneficiaries Age 75 to 84 | 1056 |
| Number Of Beneficiaries Age Greater 84 | 595 |
| Number Of Female Beneficiaries | 1520 |
| Number Of Male Beneficiaries | 1462 |
| Number Of Non Hispanic White Beneficiaries | 2249 |
| Number Of Black or African American Beneficiaries | 664 |
| Number Of AsianPacific Islander Beneficiaries | 24 |
| Number Of Hispanic Beneficiaries | 27 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2586 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 396 |
| Percent Of With Atrial Fibrillation | 37 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 40 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 57 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.7643 |