| National Provider Identifier [NPI]: | 1467414987 |
| Last Name Of The Provider | GILLESPIE |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3120 SOUTHWEST FWY |
| Street Address 2 Of The Provider | SUITE 530 |
| City Of The Provider | HOUSTON |
| Zip Code Of The Provider | 770984509 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 227 |
| Number Of Services | 5549 |
| Number Of Medicare Beneficiaries | 2667 |
| Total Submitted Charge Amount | 904841 |
| Total Medicare Allowed Amount | 168101.44 |
| Total Medicare Payment Amount | 125027.42 |
| Total Medicare Standardized Payment Amount | 126167.73 |
| 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 | 227 |
| Number Of Medical Services | 5549 |
| Number Of Medicare Beneficiaries With Medical Services | 2667 |
| Total Medical Submitted Charge Amount | 904841 |
| Total Medical Medicare Allowed Amount | 168101.44 |
| Total Medical Medicare Payment Amount | 125027.42 |
| Total Medical Medicare Standardized Payment Amount | 126167.73 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 350 |
| Number Of Beneficiaries Age 65 to 74 | 1090 |
| Number Of Beneficiaries Age 75 to 84 | 809 |
| Number Of Beneficiaries Age Greater 84 | 418 |
| Number Of Female Beneficiaries | 1605 |
| Number Of Male Beneficiaries | 1062 |
| Number Of Non Hispanic White Beneficiaries | 2203 |
| Number Of Black or African American Beneficiaries | 183 |
| Number Of AsianPacific Islander Beneficiaries | 61 |
| Number Of Hispanic Beneficiaries | 187 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2291 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 376 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 31 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.7432 |