| National Provider Identifier [NPI]: | 1174542518 |
| Last Name Of The Provider | GOREY |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| 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 | 47 |
| Number Of Services | 2718 |
| Number Of Medicare Beneficiaries | 2050 |
| Total Submitted Charge Amount | 596143 |
| Total Medicare Allowed Amount | 181644.4 |
| Total Medicare Payment Amount | 137960.81 |
| Total Medicare Standardized Payment Amount | 132073.48 |
| 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 | 47 |
| Number Of Medical Services | 2718 |
| Number Of Medicare Beneficiaries With Medical Services | 2050 |
| Total Medical Submitted Charge Amount | 596143 |
| Total Medical Medicare Allowed Amount | 181644.4 |
| Total Medical Medicare Payment Amount | 137960.81 |
| Total Medical Medicare Standardized Payment Amount | 132073.48 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 144 |
| Number Of Beneficiaries Age 65 to 74 | 550 |
| Number Of Beneficiaries Age 75 to 84 | 726 |
| Number Of Beneficiaries Age Greater 84 | 630 |
| Number Of Female Beneficiaries | 1219 |
| Number Of Male Beneficiaries | 831 |
| Number Of Non Hispanic White Beneficiaries | 1794 |
| Number Of Black or African American Beneficiaries | 88 |
| Number Of AsianPacific Islander Beneficiaries | 83 |
| Number Of Hispanic Beneficiaries | 46 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1751 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 299 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 25 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 20 |
| Average HCC Risk Score Of Beneficiaries | 1.5389 |