| National Provider Identifier [NPI]: | 1073592606 |
| Last Name Of The Provider | GILLESPY |
| First Name Of The Provider | MARK |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1075 MASON AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | DAYTONA BEACH |
| Zip Code Of The Provider | 32117 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 136 |
| Number Of Services | 8075 |
| Number Of Medicare Beneficiaries | 908 |
| Total Submitted Charge Amount | 2044950.4 |
| Total Medicare Allowed Amount | 577405.44 |
| Total Medicare Payment Amount | 442764.77 |
| Total Medicare Standardized Payment Amount | 425740.52 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 1240 |
| Number Of Medicare Beneficiaries With Drug Services | 140 |
| Total Drug Submitted ChargeAmount | 44801 |
| Total Drug Medicare AllowedAmount | 22020.38 |
| Total Drug Medicare PaymentAmount | 17025.26 |
| Total Drug Medicare Standardized Payment Amount | 17025.26 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 130 |
| Number Of Medical Services | 6835 |
| Number Of Medicare Beneficiaries With Medical Services | 905 |
| Total Medical Submitted Charge Amount | 2000149.4 |
| Total Medical Medicare Allowed Amount | 555385.06 |
| Total Medical Medicare Payment Amount | 425739.51 |
| Total Medical Medicare Standardized Payment Amount | 408715.26 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 63 |
| Number Of Beneficiaries Age 65 to 74 | 400 |
| Number Of Beneficiaries Age 75 to 84 | 316 |
| Number Of Beneficiaries Age Greater 84 | 129 |
| Number Of Female Beneficiaries | 521 |
| Number Of Male Beneficiaries | 387 |
| Number Of Non Hispanic White Beneficiaries | 850 |
| Number Of Black or African American Beneficiaries | 33 |
| 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 | 834 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 74 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 73 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 27 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.1331 |