| National Provider Identifier [NPI]: | 1639183148 |
| Last Name Of The Provider | POTTINGER |
| First Name Of The Provider | JILL |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 304 TURNER MCCALL BLVD SW |
| Street Address 2 Of The Provider | |
| City Of The Provider | ROME |
| Zip Code Of The Provider | 301655621 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 23 |
| Number Of Services | 1065 |
| Number Of Medicare Beneficiaries | 846 |
| Total Submitted Charge Amount | 481550 |
| Total Medicare Allowed Amount | 122508.39 |
| Total Medicare Payment Amount | 94521.14 |
| Total Medicare Standardized Payment Amount | 97267.11 |
| 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 | 23 |
| Number Of Medical Services | 1065 |
| Number Of Medicare Beneficiaries With Medical Services | 846 |
| Total Medical Submitted Charge Amount | 481550 |
| Total Medical Medicare Allowed Amount | 122508.39 |
| Total Medical Medicare Payment Amount | 94521.14 |
| Total Medical Medicare Standardized Payment Amount | 97267.11 |
| Average Age Of Beneficiaries | 65 |
| Number Of Beneficiaries Age Less65 | 365 |
| Number Of Beneficiaries Age 65 to 74 | 207 |
| Number Of Beneficiaries Age 75 to 84 | 175 |
| Number Of Beneficiaries Age Greater 84 | 99 |
| Number Of Female Beneficiaries | 472 |
| Number Of Male Beneficiaries | 374 |
| Number Of Non Hispanic White Beneficiaries | 741 |
| Number Of Black or African American Beneficiaries | 82 |
| 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 | 427 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 419 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 23 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 37 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 38 |
| Percent Of With Depression | 48 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 50 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 19 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 2.0086 |