| National Provider Identifier [NPI]: | 1447393301 |
| Last Name Of The Provider | TILLINGHAST |
| First Name Of The Provider | JEFFREY |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1040 N MASON RD |
| Street Address 2 Of The Provider | SUITE 115 |
| City Of The Provider | SAINT LOUIS |
| Zip Code Of The Provider | 631416399 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Allergy/Immunology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 44 |
| Number Of Services | 10370 |
| Number Of Medicare Beneficiaries | 395 |
| Total Submitted Charge Amount | 402339.5 |
| Total Medicare Allowed Amount | 249528.03 |
| Total Medicare Payment Amount | 189014.83 |
| Total Medicare Standardized Payment Amount | 186077.1 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 4740 |
| Number Of Medicare Beneficiaries With Drug Services | 122 |
| Total Drug Submitted ChargeAmount | 164221.5 |
| Total Drug Medicare AllowedAmount | 125213.2 |
| Total Drug Medicare PaymentAmount | 98867.52 |
| Total Drug Medicare Standardized Payment Amount | 98867.52 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 34 |
| Number Of Medical Services | 5630 |
| Number Of Medicare Beneficiaries With Medical Services | 395 |
| Total Medical Submitted Charge Amount | 238118 |
| Total Medical Medicare Allowed Amount | 124314.83 |
| Total Medical Medicare Payment Amount | 90147.31 |
| Total Medical Medicare Standardized Payment Amount | 87209.58 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 34 |
| Number Of Beneficiaries Age 65 to 74 | 232 |
| Number Of Beneficiaries Age 75 to 84 | 106 |
| Number Of Beneficiaries Age Greater 84 | 23 |
| Number Of Female Beneficiaries | 245 |
| Number Of Male Beneficiaries | 150 |
| Number Of Non Hispanic White Beneficiaries | 361 |
| Number Of Black or African American Beneficiaries | 20 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 383 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 12 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 3 |
| Percent Of With Asthma | 28 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 7 |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 18 |
| Percent Of With Hyperlipidemia | 43 |
| Percent Of With Hypertension | 49 |
| Percent Of With Ischemic Heart Disease | 24 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8383 |