| National Provider Identifier [NPI]: | 1922181593 |
| Last Name Of The Provider | GILL |
| First Name Of The Provider | RAJI |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1500 EAST DOWNING |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | TAHLEQUAH |
| Zip Code Of The Provider | 74464 |
| State Code Of The Provider | OK |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 38 |
| Number Of Services | 2906 |
| Number Of Medicare Beneficiaries | 413 |
| Total Submitted Charge Amount | 259444.45 |
| Total Medicare Allowed Amount | 140324.04 |
| Total Medicare Payment Amount | 103321.47 |
| Total Medicare Standardized Payment Amount | 112857.5 |
| Drug Suppress Indicator | * |
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| Medical SuppressIndicator | # |
| Number Of HCPCS Associated With MedicalServices | |
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| Number Of Medicare Beneficiaries With Medical Services | |
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| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 77 |
| Number Of Beneficiaries Age 65 to 74 | 181 |
| Number Of Beneficiaries Age 75 to 84 | 127 |
| Number Of Beneficiaries Age Greater 84 | 28 |
| Number Of Female Beneficiaries | 118 |
| Number Of Male Beneficiaries | 295 |
| Number Of Non Hispanic White Beneficiaries | 306 |
| Number Of Black or African American Beneficiaries | 34 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 57 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 297 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 116 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.2761 |