| National Provider Identifier [NPI]: | 1750335014 |
| Last Name Of The Provider | NOBLE |
| First Name Of The Provider | GAVIN |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1501 NE MEDICAL CENTER DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | BEND |
| Zip Code Of The Provider | 977016051 |
| State Code Of The Provider | OR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 90 |
| Number Of Services | 7120 |
| Number Of Medicare Beneficiaries | 2257 |
| Total Submitted Charge Amount | 2098879.76 |
| Total Medicare Allowed Amount | 662388.96 |
| Total Medicare Payment Amount | 503167.23 |
| Total Medicare Standardized Payment Amount | 519819.85 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 603 |
| Number Of Medicare Beneficiaries With Drug Services | 166 |
| Total Drug Submitted ChargeAmount | 74019.7 |
| Total Drug Medicare AllowedAmount | 29529.69 |
| Total Drug Medicare PaymentAmount | 23002.16 |
| Total Drug Medicare Standardized Payment Amount | 23002.16 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 82 |
| Number Of Medical Services | 6517 |
| Number Of Medicare Beneficiaries With Medical Services | 2256 |
| Total Medical Submitted Charge Amount | 2024860.06 |
| Total Medical Medicare Allowed Amount | 632859.27 |
| Total Medical Medicare Payment Amount | 480165.07 |
| Total Medical Medicare Standardized Payment Amount | 496817.69 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 202 |
| Number Of Beneficiaries Age 65 to 74 | 992 |
| Number Of Beneficiaries Age 75 to 84 | 703 |
| Number Of Beneficiaries Age Greater 84 | 360 |
| Number Of Female Beneficiaries | 1107 |
| Number Of Male Beneficiaries | 1150 |
| Number Of Non Hispanic White Beneficiaries | 2147 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 40 |
| Number Of American Indian Alaska Native Beneficiaries | 23 |
| Number Of Beneficiaries With Race Not Else where Classified | 26 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2002 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 255 |
| Percent Of With Atrial Fibrillation | 27 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 53 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.3455 |