| National Provider Identifier [NPI]: | 1356323174 |
| Last Name Of The Provider | GIL |
| First Name Of The Provider | HOLLY |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 20 CATAMORE BLVD |
| Street Address 2 Of The Provider | RHODE ISLAND MEDICAL IMAGING |
| City Of The Provider | EAST PROVIDENCE |
| Zip Code Of The Provider | 029141204 |
| State Code Of The Provider | RI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 128 |
| Number Of Services | 9746 |
| Number Of Medicare Beneficiaries | 2180 |
| Total Submitted Charge Amount | 604134 |
| Total Medicare Allowed Amount | 169938.05 |
| Total Medicare Payment Amount | 125790.32 |
| Total Medicare Standardized Payment Amount | 122021.49 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 6415 |
| Number Of Medicare Beneficiaries With Drug Services | 54 |
| Total Drug Submitted ChargeAmount | 5094 |
| Total Drug Medicare AllowedAmount | 1840.86 |
| Total Drug Medicare PaymentAmount | 1396.62 |
| Total Drug Medicare Standardized Payment Amount | 1396.62 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 125 |
| Number Of Medical Services | 3331 |
| Number Of Medicare Beneficiaries With Medical Services | 2180 |
| Total Medical Submitted Charge Amount | 599040 |
| Total Medical Medicare Allowed Amount | 168097.19 |
| Total Medical Medicare Payment Amount | 124393.7 |
| Total Medical Medicare Standardized Payment Amount | 120624.87 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 502 |
| Number Of Beneficiaries Age 65 to 74 | 780 |
| Number Of Beneficiaries Age 75 to 84 | 541 |
| Number Of Beneficiaries Age Greater 84 | 357 |
| Number Of Female Beneficiaries | 1375 |
| Number Of Male Beneficiaries | 805 |
| Number Of Non Hispanic White Beneficiaries | 1715 |
| Number Of Black or African American Beneficiaries | 119 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 258 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 57 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1428 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 752 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 38 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.5677 |