| National Provider Identifier [NPI]: | 1215120811 |
| Last Name Of The Provider | MCQUILLAN |
| First Name Of The Provider | MOIRA |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 10961 S KEDZIE AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | CHICAGO |
| Zip Code Of The Provider | 606552219 |
| 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 | 60 |
| Number Of Services | 626 |
| Number Of Medicare Beneficiaries | 202 |
| Total Submitted Charge Amount | 74753 |
| Total Medicare Allowed Amount | 51357.49 |
| Total Medicare Payment Amount | 35901.73 |
| Total Medicare Standardized Payment Amount | 33796.17 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 27 |
| Number Of Medicare Beneficiaries With Drug Services | 21 |
| Total Drug Submitted ChargeAmount | 634 |
| Total Drug Medicare AllowedAmount | 446.15 |
| Total Drug Medicare PaymentAmount | 427.78 |
| Total Drug Medicare Standardized Payment Amount | 427.78 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 52 |
| Number Of Medical Services | 599 |
| Number Of Medicare Beneficiaries With Medical Services | 202 |
| Total Medical Submitted Charge Amount | 74119 |
| Total Medical Medicare Allowed Amount | 50911.34 |
| Total Medical Medicare Payment Amount | 35473.95 |
| Total Medical Medicare Standardized Payment Amount | 33368.39 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 14 |
| Number Of Beneficiaries Age 65 to 74 | 55 |
| Number Of Beneficiaries Age 75 to 84 | 70 |
| Number Of Beneficiaries Age Greater 84 | 63 |
| Number Of Female Beneficiaries | 161 |
| Number Of Male Beneficiaries | 41 |
| Number Of Non Hispanic White Beneficiaries | 187 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| 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 | 179 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 23 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.2477 |