| National Provider Identifier [NPI]: | 1962448134 |
| Last Name Of The Provider | HIXSON |
| First Name Of The Provider | GORDON |
| 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 | 1751 GUNBARREL RD |
| Street Address 2 Of The Provider | SUITE 101A |
| City Of The Provider | CHATTANOOGA |
| Zip Code Of The Provider | 374217162 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 20 |
| Number Of Services | 8705 |
| Number Of Medicare Beneficiaries | 657 |
| Total Submitted Charge Amount | 534278 |
| Total Medicare Allowed Amount | 215262.23 |
| Total Medicare Payment Amount | 173051.4 |
| Total Medicare Standardized Payment Amount | 184360.91 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 7833 |
| Number Of Medicare Beneficiaries With Drug Services | 159 |
| Total Drug Submitted ChargeAmount | 315958 |
| Total Drug Medicare AllowedAmount | 127139.04 |
| Total Drug Medicare PaymentAmount | 97542.13 |
| Total Drug Medicare Standardized Payment Amount | 97542.13 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 16 |
| Number Of Medical Services | 872 |
| Number Of Medicare Beneficiaries With Medical Services | 656 |
| Total Medical Submitted Charge Amount | 218320 |
| Total Medical Medicare Allowed Amount | 88123.19 |
| Total Medical Medicare Payment Amount | 75509.27 |
| Total Medical Medicare Standardized Payment Amount | 86818.78 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 152 |
| Number Of Beneficiaries Age 65 to 74 | 324 |
| Number Of Beneficiaries Age 75 to 84 | 136 |
| Number Of Beneficiaries Age Greater 84 | 45 |
| Number Of Female Beneficiaries | 643 |
| Number Of Male Beneficiaries | 14 |
| Number Of Non Hispanic White Beneficiaries | 531 |
| Number Of Black or African American Beneficiaries | 112 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 533 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 124 |
| Percent Of With Atrial Fibrillation | 5 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 5 |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 58 |
| Percent Of With Ischemic Heart Disease | 16 |
| Percent Of With Osteoporosis | 24 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 2 |
| Average HCC Risk Score Of Beneficiaries | 0.8774 |