| National Provider Identifier [NPI]: | 1417929373 |
| Last Name Of The Provider | GIBBS |
| First Name Of The Provider | GORDON |
| Middle Initial Of The Provider | F |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 115 E RIVERWALK |
| Street Address 2 Of The Provider | UNIT 200 |
| City Of The Provider | PUEBLO |
| Zip Code Of The Provider | 810033308 |
| State Code Of The Provider | CO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 307 |
| Number Of Services | 7119 |
| Number Of Medicare Beneficiaries | 3654 |
| Total Submitted Charge Amount | 2408957.46 |
| Total Medicare Allowed Amount | 707307.71 |
| Total Medicare Payment Amount | 531637.01 |
| Total Medicare Standardized Payment Amount | 528877.88 |
| Drug Suppress Indicator | * |
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| Medical SuppressIndicator | # |
| Number Of HCPCS Associated With MedicalServices | |
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| Number Of Medicare Beneficiaries With Medical Services | |
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| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 768 |
| Number Of Beneficiaries Age 65 to 74 | 1332 |
| Number Of Beneficiaries Age 75 to 84 | 1044 |
| Number Of Beneficiaries Age Greater 84 | 510 |
| Number Of Female Beneficiaries | 2153 |
| Number Of Male Beneficiaries | 1501 |
| Number Of Non Hispanic White Beneficiaries | 2711 |
| Number Of Black or African American Beneficiaries | 55 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 836 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 31 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2652 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1002 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.5243 |