| National Provider Identifier [NPI]: | 1942246350 |
| Last Name Of The Provider | GALLAGHER |
| First Name Of The Provider | MITCHELL |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2900 12TH AVE N |
| Street Address 2 Of The Provider | SUITE 210W |
| City Of The Provider | BILLINGS |
| Zip Code Of The Provider | 591017506 |
| State Code Of The Provider | MT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 180 |
| Number Of Services | 5017 |
| Number Of Medicare Beneficiaries | 2843 |
| Total Submitted Charge Amount | 503103 |
| Total Medicare Allowed Amount | 146411.26 |
| Total Medicare Payment Amount | 113652.83 |
| Total Medicare Standardized Payment Amount | 114203.14 |
| 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 | 180 |
| Number Of Medical Services | 5017 |
| Number Of Medicare Beneficiaries With Medical Services | 2843 |
| Total Medical Submitted Charge Amount | 503103 |
| Total Medical Medicare Allowed Amount | 146411.26 |
| Total Medical Medicare Payment Amount | 113652.83 |
| Total Medical Medicare Standardized Payment Amount | 114203.14 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 376 |
| Number Of Beneficiaries Age 65 to 74 | 1263 |
| Number Of Beneficiaries Age 75 to 84 | 852 |
| Number Of Beneficiaries Age Greater 84 | 352 |
| Number Of Female Beneficiaries | 1968 |
| Number Of Male Beneficiaries | 875 |
| Number Of Non Hispanic White Beneficiaries | 2595 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 56 |
| Number Of American Indian Alaska Native Beneficiaries | 140 |
| Number Of Beneficiaries With Race Not Else where Classified | 40 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2379 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 464 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.2038 |