| National Provider Identifier [NPI]: | 1629069679 |
| Last Name Of The Provider | GILL |
| First Name Of The Provider | TARIQ |
| 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 | 711 TROY-SCHENECTADY ROAD |
| Street Address 2 Of The Provider | |
| City Of The Provider | LATHAM |
| Zip Code Of The Provider | 12110 |
| State Code Of The Provider | NY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 140 |
| Number Of Services | 16770 |
| Number Of Medicare Beneficiaries | 2719 |
| Total Submitted Charge Amount | 618540.54 |
| Total Medicare Allowed Amount | 264300.67 |
| Total Medicare Payment Amount | 205940.7 |
| Total Medicare Standardized Payment Amount | 220831.02 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 12454 |
| Number Of Medicare Beneficiaries With Drug Services | 163 |
| Total Drug Submitted ChargeAmount | 15008 |
| Total Drug Medicare AllowedAmount | 2856.46 |
| Total Drug Medicare PaymentAmount | 2117.71 |
| Total Drug Medicare Standardized Payment Amount | 2117.71 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 135 |
| Number Of Medical Services | 4316 |
| Number Of Medicare Beneficiaries With Medical Services | 2718 |
| Total Medical Submitted Charge Amount | 603532.54 |
| Total Medical Medicare Allowed Amount | 261444.21 |
| Total Medical Medicare Payment Amount | 203822.99 |
| Total Medical Medicare Standardized Payment Amount | 218713.31 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 524 |
| Number Of Beneficiaries Age 65 to 74 | 1119 |
| Number Of Beneficiaries Age 75 to 84 | 679 |
| Number Of Beneficiaries Age Greater 84 | 397 |
| Number Of Female Beneficiaries | 1713 |
| Number Of Male Beneficiaries | 1006 |
| Number Of Non Hispanic White Beneficiaries | 2486 |
| Number Of Black or African American Beneficiaries | 110 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 37 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 54 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2044 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 675 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.4151 |