| National Provider Identifier [NPI]: | 1689644478 |
| Last Name Of The Provider | BANKS-GILES |
| First Name Of The Provider | HOLLI |
| Middle Initial Of The Provider | N |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 215 E BOND AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | WEST MEMPHIS |
| Zip Code Of The Provider | 723013550 |
| State Code Of The Provider | AR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 25 |
| Number Of Services | 689 |
| Number Of Medicare Beneficiaries | 365 |
| Total Submitted Charge Amount | 26282 |
| Total Medicare Allowed Amount | 8440.85 |
| Total Medicare Payment Amount | 6618.32 |
| Total Medicare Standardized Payment Amount | 7022.78 |
| 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 | 25 |
| Number Of Medical Services | 689 |
| Number Of Medicare Beneficiaries With Medical Services | 365 |
| Total Medical Submitted Charge Amount | 26282 |
| Total Medical Medicare Allowed Amount | 8440.85 |
| Total Medical Medicare Payment Amount | 6618.32 |
| Total Medical Medicare Standardized Payment Amount | 7022.78 |
| Average Age Of Beneficiaries | 62 |
| Number Of Beneficiaries Age Less65 | 194 |
| Number Of Beneficiaries Age 65 to 74 | 106 |
| Number Of Beneficiaries Age 75 to 84 | 46 |
| Number Of Beneficiaries Age Greater 84 | 19 |
| Number Of Female Beneficiaries | 208 |
| Number Of Male Beneficiaries | 157 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | 294 |
| 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 | 116 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 249 |
| Percent Of With Atrial Fibrillation | 3 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 28 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 23 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.4456 |