National Provider Identifier [NPI]: |
1174794564 |
Last Name Of The Provider |
GILL |
First Name Of The Provider |
STEPHANIE |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
500 UNIVERSITY DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
HERSHEY |
Zip Code Of The Provider |
170332360 |
State Code Of The Provider |
PA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
18 |
Number Of Services |
342 |
Number Of Medicare Beneficiaries |
137 |
Total Submitted Charge Amount |
66246 |
Total Medicare Allowed Amount |
22962.78 |
Total Medicare Payment Amount |
16466.82 |
Total Medicare Standardized Payment Amount |
17065.27 |
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 |
18 |
Number Of Medical Services |
342 |
Number Of Medicare Beneficiaries With Medical Services |
137 |
Total Medical Submitted Charge Amount |
66246 |
Total Medical Medicare Allowed Amount |
22962.78 |
Total Medical Medicare Payment Amount |
16466.82 |
Total Medical Medicare Standardized Payment Amount |
17065.27 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
29 |
Number Of Beneficiaries Age 65 to 74 |
52 |
Number Of Beneficiaries Age 75 to 84 |
38 |
Number Of Beneficiaries Age Greater 84 |
18 |
Number Of Female Beneficiaries |
87 |
Number Of Male Beneficiaries |
50 |
Number Of Non Hispanic White Beneficiaries |
124 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
112 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
25 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
22 |
Percent Of With Chronic Kidney Disease |
27 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.3764 |