| National Provider Identifier [NPI]: | 1144294232 |
| Last Name Of The Provider | GIBBONS |
| First Name Of The Provider | EDWARD |
| Middle Initial Of The Provider | F |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 325 9TH AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | SEATTLE |
| Zip Code Of The Provider | 981042420 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 52 |
| Number Of Services | 2485 |
| Number Of Medicare Beneficiaries | 1285 |
| Total Submitted Charge Amount | 210101.96 |
| Total Medicare Allowed Amount | 83141.97 |
| Total Medicare Payment Amount | 62455.52 |
| Total Medicare Standardized Payment Amount | 59916.29 |
| 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 | 52 |
| Number Of Medical Services | 2485 |
| Number Of Medicare Beneficiaries With Medical Services | 1285 |
| Total Medical Submitted Charge Amount | 210101.96 |
| Total Medical Medicare Allowed Amount | 83141.97 |
| Total Medical Medicare Payment Amount | 62455.52 |
| Total Medical Medicare Standardized Payment Amount | 59916.29 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 442 |
| Number Of Beneficiaries Age 65 to 74 | 444 |
| Number Of Beneficiaries Age 75 to 84 | 251 |
| Number Of Beneficiaries Age Greater 84 | 148 |
| Number Of Female Beneficiaries | 500 |
| Number Of Male Beneficiaries | 785 |
| Number Of Non Hispanic White Beneficiaries | 774 |
| Number Of Black or African American Beneficiaries | 229 |
| Number Of AsianPacific Islander Beneficiaries | 154 |
| Number Of Hispanic Beneficiaries | 79 |
| Number Of American Indian Alaska Native Beneficiaries | 24 |
| Number Of Beneficiaries With Race Not Else where Classified | 25 |
| Number Of Beneficiaries With Medicare Only Entitlement | 513 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 772 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 35 |
| Percent Of With Chronic Kidney Disease | 45 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 38 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 29 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 17 |
| Percent Of With Stroke | 16 |
| Average HCC Risk Score Of Beneficiaries | 2.0104 |