| National Provider Identifier [NPI]: | 1124357926 |
| Last Name Of The Provider | GILL |
| First Name Of The Provider | BLAIR |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 70 DOCTORS PARK |
| Street Address 2 Of The Provider | |
| City Of The Provider | CAPE GIRARDEAU |
| Zip Code Of The Provider | 637034928 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 294 |
| Number Of Services | 5962 |
| Number Of Medicare Beneficiaries | 3455 |
| Total Submitted Charge Amount | 1278696 |
| Total Medicare Allowed Amount | 345623.73 |
| Total Medicare Payment Amount | 266835.83 |
| Total Medicare Standardized Payment Amount | 278524.99 |
| 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 | 294 |
| Number Of Medical Services | 5962 |
| Number Of Medicare Beneficiaries With Medical Services | 3455 |
| Total Medical Submitted Charge Amount | 1278696 |
| Total Medical Medicare Allowed Amount | 345623.73 |
| Total Medical Medicare Payment Amount | 266835.83 |
| Total Medical Medicare Standardized Payment Amount | 278524.99 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 879 |
| Number Of Beneficiaries Age 65 to 74 | 1144 |
| Number Of Beneficiaries Age 75 to 84 | 940 |
| Number Of Beneficiaries Age Greater 84 | 492 |
| Number Of Female Beneficiaries | 1973 |
| Number Of Male Beneficiaries | 1482 |
| Number Of Non Hispanic White Beneficiaries | 3195 |
| Number Of Black or African American Beneficiaries | 225 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 17 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2138 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1317 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 37 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 44 |
| Percent Of With Depression | 38 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 55 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 2.0331 |