| National Provider Identifier [NPI]: | 1043335136 |
| Last Name Of The Provider | GILLILAND |
| First Name Of The Provider | COREY |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 731 LEIGHTON AVE |
| Street Address 2 Of The Provider | STE 407 |
| City Of The Provider | ANNISTON |
| Zip Code Of The Provider | 362075761 |
| State Code Of The Provider | AL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | General Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 27 |
| Number Of Services | 209 |
| Number Of Medicare Beneficiaries | 50 |
| Total Submitted Charge Amount | 12666.3 |
| Total Medicare Allowed Amount | 9532.69 |
| Total Medicare Payment Amount | 4151.51 |
| Total Medicare Standardized Payment Amount | 4816.61 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 45 |
| Number Of Medicare Beneficiaries With Drug Services | 17 |
| Total Drug Submitted ChargeAmount | 451.5 |
| Total Drug Medicare AllowedAmount | 130.8 |
| Total Drug Medicare PaymentAmount | 70.08 |
| Total Drug Medicare Standardized Payment Amount | 70.08 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 22 |
| Number Of Medical Services | 164 |
| Number Of Medicare Beneficiaries With Medical Services | 50 |
| Total Medical Submitted Charge Amount | 12214.8 |
| Total Medical Medicare Allowed Amount | 9401.89 |
| Total Medical Medicare Payment Amount | 4081.43 |
| Total Medical Medicare Standardized Payment Amount | 4746.53 |
| Average Age Of Beneficiaries | 65 |
| Number Of Beneficiaries Age Less65 | 22 |
| Number Of Beneficiaries Age 65 to 74 | 15 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 31 |
| Number Of Male Beneficiaries | 19 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| 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 | 32 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 18 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 46 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.3557 |