| National Provider Identifier [NPI]: | 1952383978 |
| Last Name Of The Provider | GILLUM |
| First Name Of The Provider | WILLIAM |
| Middle Initial Of The Provider | N |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1519 E 6TH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | WESLACO |
| Zip Code Of The Provider | 785966605 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 29 |
| Number Of Services | 3361 |
| Number Of Medicare Beneficiaries | 1649 |
| Total Submitted Charge Amount | 1351731 |
| Total Medicare Allowed Amount | 571618.94 |
| Total Medicare Payment Amount | 412024.96 |
| Total Medicare Standardized Payment Amount | 438891.37 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 29 |
| Number Of Medical Services | 3361 |
| Number Of Medicare Beneficiaries With Medical Services | 1649 |
| Total Medical Submitted Charge Amount | 1351731 |
| Total Medical Medicare Allowed Amount | 571618.94 |
| Total Medical Medicare Payment Amount | 412024.96 |
| Total Medical Medicare Standardized Payment Amount | 438891.37 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 47 |
| Number Of Beneficiaries Age 65 to 74 | 503 |
| Number Of Beneficiaries Age 75 to 84 | 788 |
| Number Of Beneficiaries Age Greater 84 | 311 |
| Number Of Female Beneficiaries | 1019 |
| Number Of Male Beneficiaries | 630 |
| Number Of Non Hispanic White Beneficiaries | 874 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 760 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1153 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 496 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.1789 |