| National Provider Identifier [NPI]: | 1033159959 |
| Last Name Of The Provider | TUMILTY |
| First Name Of The Provider | BETH |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | DO |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1302 FRANKLIN AVE |
| Street Address 2 Of The Provider | #4500 |
| City Of The Provider | NORMAL |
| Zip Code Of The Provider | 617613551 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 60 |
| Number Of Services | 4640 |
| Number Of Medicare Beneficiaries | 1806 |
| Total Submitted Charge Amount | 838332 |
| Total Medicare Allowed Amount | 354356.17 |
| Total Medicare Payment Amount | 270617.62 |
| Total Medicare Standardized Payment Amount | 280888.93 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 425 |
| Number Of Medicare Beneficiaries With Drug Services | 108 |
| Total Drug Submitted ChargeAmount | 33780 |
| Total Drug Medicare AllowedAmount | 22527.19 |
| Total Drug Medicare PaymentAmount | 17542.88 |
| Total Drug Medicare Standardized Payment Amount | 17542.88 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 58 |
| Number Of Medical Services | 4215 |
| Number Of Medicare Beneficiaries With Medical Services | 1806 |
| Total Medical Submitted Charge Amount | 804552 |
| Total Medical Medicare Allowed Amount | 331828.98 |
| Total Medical Medicare Payment Amount | 253074.74 |
| Total Medical Medicare Standardized Payment Amount | 263346.05 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 241 |
| Number Of Beneficiaries Age 65 to 74 | 593 |
| Number Of Beneficiaries Age 75 to 84 | 584 |
| Number Of Beneficiaries Age Greater 84 | 388 |
| Number Of Female Beneficiaries | 971 |
| Number Of Male Beneficiaries | 835 |
| Number Of Non Hispanic White Beneficiaries | 1697 |
| Number Of Black or African American Beneficiaries | 63 |
| 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 | 28 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1496 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 310 |
| Percent Of With Atrial Fibrillation | 32 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 40 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 72 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 63 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.5491 |