| National Provider Identifier [NPI]: | 1689647547 |
| Last Name Of The Provider | GILL |
| First Name Of The Provider | VIJAY |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2152 S VINEYARD |
| Street Address 2 Of The Provider | SUITE 119 |
| City Of The Provider | MESA |
| Zip Code Of The Provider | 852106871 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 47 |
| Number Of Services | 1150 |
| Number Of Medicare Beneficiaries | 137 |
| Total Submitted Charge Amount | 142196 |
| Total Medicare Allowed Amount | 103280.51 |
| Total Medicare Payment Amount | 77300.51 |
| Total Medicare Standardized Payment Amount | 78024.67 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 178 |
| Number Of Medicare Beneficiaries With Drug Services | 89 |
| Total Drug Submitted ChargeAmount | 16039 |
| Total Drug Medicare AllowedAmount | 10723.36 |
| Total Drug Medicare PaymentAmount | 10447.39 |
| Total Drug Medicare Standardized Payment Amount | 10447.39 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 37 |
| Number Of Medical Services | 972 |
| Number Of Medicare Beneficiaries With Medical Services | 137 |
| Total Medical Submitted Charge Amount | 126157 |
| Total Medical Medicare Allowed Amount | 92557.15 |
| Total Medical Medicare Payment Amount | 66853.12 |
| Total Medical Medicare Standardized Payment Amount | 67577.28 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 21 |
| Number Of Beneficiaries Age 65 to 74 | 60 |
| Number Of Beneficiaries Age 75 to 84 | 39 |
| Number Of Beneficiaries Age Greater 84 | 17 |
| Number Of Female Beneficiaries | 69 |
| Number Of Male Beneficiaries | 68 |
| Number Of Non Hispanic White Beneficiaries | 105 |
| Number Of Black or African American Beneficiaries | 11 |
| 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 | 119 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 18 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 11 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 37 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 22 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 30 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.312 |