| National Provider Identifier [NPI]: | 1326083361 |
| Last Name Of The Provider | HUBBARD |
| First Name Of The Provider | JAMES |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 800 E 20TH ST |
| Street Address 2 Of The Provider | SUITE 110 |
| City Of The Provider | CHEYENNE |
| Zip Code Of The Provider | 820013859 |
| State Code Of The Provider | WY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 251 |
| Number Of Services | 13168 |
| Number Of Medicare Beneficiaries | 4034 |
| Total Submitted Charge Amount | 477813.25 |
| Total Medicare Allowed Amount | 353950.28 |
| Total Medicare Payment Amount | 275754.82 |
| Total Medicare Standardized Payment Amount | 280755.19 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 5740 |
| Number Of Medicare Beneficiaries With Drug Services | 86 |
| Total Drug Submitted ChargeAmount | 1693.43 |
| Total Drug Medicare AllowedAmount | 1498.07 |
| Total Drug Medicare PaymentAmount | 1169.93 |
| Total Drug Medicare Standardized Payment Amount | 1169.93 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 247 |
| Number Of Medical Services | 7428 |
| Number Of Medicare Beneficiaries With Medical Services | 4033 |
| Total Medical Submitted Charge Amount | 476119.82 |
| Total Medical Medicare Allowed Amount | 352452.21 |
| Total Medical Medicare Payment Amount | 274584.89 |
| Total Medical Medicare Standardized Payment Amount | 279585.26 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 591 |
| Number Of Beneficiaries Age 65 to 74 | 1566 |
| Number Of Beneficiaries Age 75 to 84 | 1283 |
| Number Of Beneficiaries Age Greater 84 | 594 |
| Number Of Female Beneficiaries | 2595 |
| Number Of Male Beneficiaries | 1439 |
| Number Of Non Hispanic White Beneficiaries | 3607 |
| Number Of Black or African American Beneficiaries | 60 |
| Number Of AsianPacific Islander Beneficiaries | 21 |
| Number Of Hispanic Beneficiaries | 289 |
| Number Of American Indian Alaska Native Beneficiaries | 17 |
| Number Of Beneficiaries With Race Not Else where Classified | 40 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3205 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 829 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 41 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.2454 |