| National Provider Identifier [NPI]: | 1336358324 |
| Last Name Of The Provider | GALLAGHER |
| First Name Of The Provider | BRIAN |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5950 UNIVERSITY AVE |
| Street Address 2 Of The Provider | STE 341 |
| City Of The Provider | WEST DES MOINES |
| Zip Code Of The Provider | 502668216 |
| State Code Of The Provider | IA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 134 |
| Number Of Services | 5878 |
| Number Of Medicare Beneficiaries | 1276 |
| Total Submitted Charge Amount | 1342654.05 |
| Total Medicare Allowed Amount | 414494.97 |
| Total Medicare Payment Amount | 313303.54 |
| Total Medicare Standardized Payment Amount | 335138.24 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 1288 |
| Number Of Medicare Beneficiaries With Drug Services | 79 |
| Total Drug Submitted ChargeAmount | 295226 |
| Total Drug Medicare AllowedAmount | 68070.89 |
| Total Drug Medicare PaymentAmount | 52898.54 |
| Total Drug Medicare Standardized Payment Amount | 52898.54 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 128 |
| Number Of Medical Services | 4590 |
| Number Of Medicare Beneficiaries With Medical Services | 1276 |
| Total Medical Submitted Charge Amount | 1047428.05 |
| Total Medical Medicare Allowed Amount | 346424.08 |
| Total Medical Medicare Payment Amount | 260405 |
| Total Medical Medicare Standardized Payment Amount | 282239.7 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 135 |
| Number Of Beneficiaries Age 65 to 74 | 509 |
| Number Of Beneficiaries Age 75 to 84 | 416 |
| Number Of Beneficiaries Age Greater 84 | 216 |
| Number Of Female Beneficiaries | 349 |
| Number Of Male Beneficiaries | 927 |
| Number Of Non Hispanic White Beneficiaries | 1219 |
| Number Of Black or African American Beneficiaries | 24 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 15 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1110 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 166 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.3282 |