| National Provider Identifier [NPI]: | 1992813745 |
| Last Name Of The Provider | ELLISON |
| First Name Of The Provider | JAMES |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 222 S WOODS MILL RD |
| Street Address 2 Of The Provider | SUITE 310N |
| City Of The Provider | CHESTERFIELD |
| Zip Code Of The Provider | 630173625 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 57 |
| Number Of Services | 5214 |
| Number Of Medicare Beneficiaries | 2230 |
| Total Submitted Charge Amount | 473927 |
| Total Medicare Allowed Amount | 215897.03 |
| Total Medicare Payment Amount | 160596.28 |
| Total Medicare Standardized Payment Amount | 164136.5 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 44 |
| Number Of Medicare Beneficiaries With Drug Services | 41 |
| Total Drug Submitted ChargeAmount | 3250 |
| Total Drug Medicare AllowedAmount | 1579.58 |
| Total Drug Medicare PaymentAmount | 1547.92 |
| Total Drug Medicare Standardized Payment Amount | 1547.92 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 53 |
| Number Of Medical Services | 5170 |
| Number Of Medicare Beneficiaries With Medical Services | 2230 |
| Total Medical Submitted Charge Amount | 470677 |
| Total Medical Medicare Allowed Amount | 214317.45 |
| Total Medical Medicare Payment Amount | 159048.36 |
| Total Medical Medicare Standardized Payment Amount | 162588.58 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 164 |
| Number Of Beneficiaries Age 65 to 74 | 783 |
| Number Of Beneficiaries Age 75 to 84 | 779 |
| Number Of Beneficiaries Age Greater 84 | 504 |
| Number Of Female Beneficiaries | 1148 |
| Number Of Male Beneficiaries | 1082 |
| Number Of Non Hispanic White Beneficiaries | 2050 |
| Number Of Black or African American Beneficiaries | 127 |
| Number Of AsianPacific Islander Beneficiaries | 22 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 17 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2049 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 181 |
| Percent Of With Atrial Fibrillation | 29 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 38 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 74 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 61 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 1.6145 |