| National Provider Identifier [NPI]: | 1457454670 |
| Last Name Of The Provider | GILMARTIN |
| First Name Of The Provider | WILLIAM |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 182 WEST MONTAUK HWY |
| Street Address 2 Of The Provider | BLDG B SUITE H |
| City Of The Provider | HAMPTON BAYS |
| Zip Code Of The Provider | 11946 |
| State Code Of The Provider | NY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 39 |
| Number Of Services | 1432 |
| Number Of Medicare Beneficiaries | 444 |
| Total Submitted Charge Amount | 58195.04 |
| Total Medicare Allowed Amount | 47907.7 |
| Total Medicare Payment Amount | 35295.99 |
| Total Medicare Standardized Payment Amount | 31059.14 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 48 |
| Number Of Medicare Beneficiaries With Drug Services | 44 |
| Total Drug Submitted ChargeAmount | 1522.07 |
| Total Drug Medicare AllowedAmount | 1398.31 |
| Total Drug Medicare PaymentAmount | 1331.07 |
| Total Drug Medicare Standardized Payment Amount | 1331.07 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 29 |
| Number Of Medical Services | 1384 |
| Number Of Medicare Beneficiaries With Medical Services | 442 |
| Total Medical Submitted Charge Amount | 56672.97 |
| Total Medical Medicare Allowed Amount | 46509.39 |
| Total Medical Medicare Payment Amount | 33964.92 |
| Total Medical Medicare Standardized Payment Amount | 29728.07 |
| Average Age Of Beneficiaries | 62 |
| Number Of Beneficiaries Age Less65 | 224 |
| Number Of Beneficiaries Age 65 to 74 | 145 |
| Number Of Beneficiaries Age 75 to 84 | 64 |
| Number Of Beneficiaries Age Greater 84 | 11 |
| Number Of Female Beneficiaries | 238 |
| Number Of Male Beneficiaries | 206 |
| Number Of Non Hispanic White Beneficiaries | 262 |
| Number Of Black or African American Beneficiaries | 74 |
| Number Of AsianPacific Islander Beneficiaries | 14 |
| Number Of Hispanic Beneficiaries | 83 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 119 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 325 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 25 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 15 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.242 |