| National Provider Identifier [NPI]: | 1982658563 |
| Last Name Of The Provider | IVILL |
| First Name Of The Provider | DENNIS |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1501 LANSDOWNE AVE STE 303 |
| Street Address 2 Of The Provider | |
| City Of The Provider | DARBY |
| Zip Code Of The Provider | 190231333 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physical Medicine and Rehabilitation |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 30 |
| Number Of Services | 2013 |
| Number Of Medicare Beneficiaries | 195 |
| Total Submitted Charge Amount | 181635 |
| Total Medicare Allowed Amount | 106669.79 |
| Total Medicare Payment Amount | 81600.39 |
| Total Medicare Standardized Payment Amount | 72219.15 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 1106 |
| Number Of Medicare Beneficiaries With Drug Services | 57 |
| Total Drug Submitted ChargeAmount | 9780 |
| Total Drug Medicare AllowedAmount | 4705.8 |
| Total Drug Medicare PaymentAmount | 3672.12 |
| Total Drug Medicare Standardized Payment Amount | 3672.12 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 25 |
| Number Of Medical Services | 907 |
| Number Of Medicare Beneficiaries With Medical Services | 195 |
| Total Medical Submitted Charge Amount | 171855 |
| Total Medical Medicare Allowed Amount | 101963.99 |
| Total Medical Medicare Payment Amount | 77928.27 |
| Total Medical Medicare Standardized Payment Amount | 68547.03 |
| Average Age Of Beneficiaries | 66 |
| Number Of Beneficiaries Age Less65 | 78 |
| Number Of Beneficiaries Age 65 to 74 | 63 |
| Number Of Beneficiaries Age 75 to 84 | 30 |
| Number Of Beneficiaries Age Greater 84 | 24 |
| Number Of Female Beneficiaries | 113 |
| Number Of Male Beneficiaries | 82 |
| Number Of Non Hispanic White Beneficiaries | 110 |
| 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 | 108 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 87 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 70 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 21 |
| Average HCC Risk Score Of Beneficiaries | 1.5184 |