| National Provider Identifier [NPI]: | 1649304114 |
| Last Name Of The Provider | ELLIS |
| First Name Of The Provider | MARGARET |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 600 MEMORIAL DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | BELLA VISTA |
| Zip Code Of The Provider | 727141847 |
| State Code Of The Provider | AR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 114 |
| Number Of Services | 7341 |
| Number Of Medicare Beneficiaries | 620 |
| Total Submitted Charge Amount | 575338 |
| Total Medicare Allowed Amount | 263364.41 |
| Total Medicare Payment Amount | 210318.09 |
| Total Medicare Standardized Payment Amount | 226068.17 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 13 |
| Number Of Drug Services | 448 |
| Number Of Medicare Beneficiaries With Drug Services | 380 |
| Total Drug Submitted ChargeAmount | 22161 |
| Total Drug Medicare AllowedAmount | 15167.67 |
| Total Drug Medicare PaymentAmount | 14795.98 |
| Total Drug Medicare Standardized Payment Amount | 14795.98 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 101 |
| Number Of Medical Services | 6893 |
| Number Of Medicare Beneficiaries With Medical Services | 620 |
| Total Medical Submitted Charge Amount | 553177 |
| Total Medical Medicare Allowed Amount | 248196.74 |
| Total Medical Medicare Payment Amount | 195522.11 |
| Total Medical Medicare Standardized Payment Amount | 211272.19 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 37 |
| Number Of Beneficiaries Age 65 to 74 | 261 |
| Number Of Beneficiaries Age 75 to 84 | 220 |
| Number Of Beneficiaries Age Greater 84 | 102 |
| Number Of Female Beneficiaries | 417 |
| Number Of Male Beneficiaries | 203 |
| Number Of Non Hispanic White Beneficiaries | 600 |
| 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 | 596 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 24 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 19 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0332 |