| National Provider Identifier [NPI]: | 1215012380 |
| Last Name Of The Provider | GIMBEL |
| First Name Of The Provider | RICK |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| 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 | EMERGENCY MEDICINE RM G909 |
| 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 | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 38 |
| Number Of Services | 1224 |
| Number Of Medicare Beneficiaries | 1065 |
| Total Submitted Charge Amount | 496868.56 |
| Total Medicare Allowed Amount | 191379.26 |
| Total Medicare Payment Amount | 146050.8 |
| Total Medicare Standardized Payment Amount | 135385.22 |
| 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 | 38 |
| Number Of Medical Services | 1224 |
| Number Of Medicare Beneficiaries With Medical Services | 1065 |
| Total Medical Submitted Charge Amount | 496868.56 |
| Total Medical Medicare Allowed Amount | 191379.26 |
| Total Medical Medicare Payment Amount | 146050.8 |
| Total Medical Medicare Standardized Payment Amount | 135385.22 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 107 |
| Number Of Beneficiaries Age 65 to 74 | 284 |
| Number Of Beneficiaries Age 75 to 84 | 316 |
| Number Of Beneficiaries Age Greater 84 | 358 |
| Number Of Female Beneficiaries | 632 |
| Number Of Male Beneficiaries | 433 |
| Number Of Non Hispanic White Beneficiaries | 926 |
| Number Of Black or African American Beneficiaries | 65 |
| Number Of AsianPacific Islander Beneficiaries | 37 |
| Number Of Hispanic Beneficiaries | 19 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 865 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 200 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 26 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 33 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.6787 |