National Provider Identifier [NPI]: |
1215021100 |
Last Name Of The Provider |
GILBERT |
First Name Of The Provider |
GEORGE |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5401 N KNOXVILLE AVE |
Street Address 2 Of The Provider |
SUITE 215 |
City Of The Provider |
PEORIA |
Zip Code Of The Provider |
616145098 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
58 |
Number Of Services |
3847 |
Number Of Medicare Beneficiaries |
462 |
Total Submitted Charge Amount |
425882.01 |
Total Medicare Allowed Amount |
205103.61 |
Total Medicare Payment Amount |
143454.99 |
Total Medicare Standardized Payment Amount |
148714.23 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
181 |
Number Of Medicare Beneficiaries With Drug Services |
150 |
Total Drug Submitted ChargeAmount |
8393.54 |
Total Drug Medicare AllowedAmount |
3150.29 |
Total Drug Medicare PaymentAmount |
3071.35 |
Total Drug Medicare Standardized Payment Amount |
3071.35 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
54 |
Number Of Medical Services |
3666 |
Number Of Medicare Beneficiaries With Medical Services |
462 |
Total Medical Submitted Charge Amount |
417488.47 |
Total Medical Medicare Allowed Amount |
201953.32 |
Total Medical Medicare Payment Amount |
140383.64 |
Total Medical Medicare Standardized Payment Amount |
145642.88 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
65 |
Number Of Beneficiaries Age 65 to 74 |
181 |
Number Of Beneficiaries Age 75 to 84 |
131 |
Number Of Beneficiaries Age Greater 84 |
85 |
Number Of Female Beneficiaries |
252 |
Number Of Male Beneficiaries |
210 |
Number Of Non Hispanic White Beneficiaries |
406 |
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 |
368 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
94 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
27 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
56 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.3058 |