| National Provider Identifier [NPI]: | 1932269305 |
| Last Name Of The Provider | GORE |
| First Name Of The Provider | MARGARET |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2650 RIDGE AVE |
| Street Address 2 Of The Provider | DEPARTMENT OF RADIOLOGY G507 |
| City Of The Provider | EVANSTON |
| Zip Code Of The Provider | 602011718 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 93 |
| Number Of Services | 9435 |
| Number Of Medicare Beneficiaries | 6574 |
| Total Submitted Charge Amount | 332307 |
| Total Medicare Allowed Amount | 111244.19 |
| Total Medicare Payment Amount | 82282.88 |
| Total Medicare Standardized Payment Amount | 76557.54 |
| 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 | 93 |
| Number Of Medical Services | 9435 |
| Number Of Medicare Beneficiaries With Medical Services | 6574 |
| Total Medical Submitted Charge Amount | 332307 |
| Total Medical Medicare Allowed Amount | 111244.19 |
| Total Medical Medicare Payment Amount | 82282.88 |
| Total Medical Medicare Standardized Payment Amount | 76557.54 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 441 |
| Number Of Beneficiaries Age 65 to 74 | 2078 |
| Number Of Beneficiaries Age 75 to 84 | 2221 |
| Number Of Beneficiaries Age Greater 84 | 1834 |
| Number Of Female Beneficiaries | 3919 |
| Number Of Male Beneficiaries | 2655 |
| Number Of Non Hispanic White Beneficiaries | 5651 |
| Number Of Black or African American Beneficiaries | 386 |
| Number Of AsianPacific Islander Beneficiaries | 257 |
| Number Of Hispanic Beneficiaries | 157 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 5631 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 943 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 31 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.608 |