National Provider Identifier [NPI]: |
1497869440 |
Last Name Of The Provider |
GALLO |
First Name Of The Provider |
ROBIN |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
PA-C |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
405 RUSHING DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
HERRIN |
Zip Code Of The Provider |
629483730 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
10 |
Number Of Services |
676 |
Number Of Medicare Beneficiaries |
608 |
Total Submitted Charge Amount |
80149 |
Total Medicare Allowed Amount |
52843.87 |
Total Medicare Payment Amount |
38498.49 |
Total Medicare Standardized Payment Amount |
47556.9 |
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 |
10 |
Number Of Medical Services |
676 |
Number Of Medicare Beneficiaries With Medical Services |
608 |
Total Medical Submitted Charge Amount |
80149 |
Total Medical Medicare Allowed Amount |
52843.87 |
Total Medical Medicare Payment Amount |
38498.49 |
Total Medical Medicare Standardized Payment Amount |
47556.9 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
188 |
Number Of Beneficiaries Age 65 to 74 |
270 |
Number Of Beneficiaries Age 75 to 84 |
126 |
Number Of Beneficiaries Age Greater 84 |
24 |
Number Of Female Beneficiaries |
376 |
Number Of Male Beneficiaries |
232 |
Number Of Non Hispanic White Beneficiaries |
583 |
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 |
379 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
229 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
24 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
33 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
36 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.2264 |