| National Provider Identifier [NPI]: | 1427003573 |
| Last Name Of The Provider | STILLSON |
| First Name Of The Provider | TOD |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 209 E JEFFERSON ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | PLYMOUTH |
| Zip Code Of The Provider | 465631861 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 76 |
| Number Of Services | 2321 |
| Number Of Medicare Beneficiaries | 414 |
| Total Submitted Charge Amount | 255347.4 |
| Total Medicare Allowed Amount | 153989.95 |
| Total Medicare Payment Amount | 107451.26 |
| Total Medicare Standardized Payment Amount | 115602 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 12 |
| Number Of Drug Services | 214 |
| Number Of Medicare Beneficiaries With Drug Services | 140 |
| Total Drug Submitted ChargeAmount | 6546 |
| Total Drug Medicare AllowedAmount | 3981.07 |
| Total Drug Medicare PaymentAmount | 3780.37 |
| Total Drug Medicare Standardized Payment Amount | 3780.37 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 64 |
| Number Of Medical Services | 2107 |
| Number Of Medicare Beneficiaries With Medical Services | 414 |
| Total Medical Submitted Charge Amount | 248801.4 |
| Total Medical Medicare Allowed Amount | 150008.88 |
| Total Medical Medicare Payment Amount | 103670.89 |
| Total Medical Medicare Standardized Payment Amount | 111821.63 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 59 |
| Number Of Beneficiaries Age 65 to 74 | 179 |
| Number Of Beneficiaries Age 75 to 84 | 116 |
| Number Of Beneficiaries Age Greater 84 | 60 |
| Number Of Female Beneficiaries | 260 |
| Number Of Male Beneficiaries | 154 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | 337 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 77 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.0756 |