| National Provider Identifier [NPI]: | 1447210315 |
| Last Name Of The Provider | GOREE |
| First Name Of The Provider | JEFFREY |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1970 E 53RD ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | DAVENPORT |
| Zip Code Of The Provider | 528072710 |
| State Code Of The Provider | IA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 207 |
| Number Of Services | 5230 |
| Number Of Medicare Beneficiaries | 3245 |
| Total Submitted Charge Amount | 817512.43 |
| Total Medicare Allowed Amount | 159730.38 |
| Total Medicare Payment Amount | 124244.47 |
| Total Medicare Standardized Payment Amount | 132049.61 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 121 |
| Number Of Medicare Beneficiaries With Drug Services | 17 |
| Total Drug Submitted ChargeAmount | 870.1 |
| Total Drug Medicare AllowedAmount | 236.81 |
| Total Drug Medicare PaymentAmount | 185.74 |
| Total Drug Medicare Standardized Payment Amount | 185.74 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 206 |
| Number Of Medical Services | 5109 |
| Number Of Medicare Beneficiaries With Medical Services | 3245 |
| Total Medical Submitted Charge Amount | 816642.33 |
| Total Medical Medicare Allowed Amount | 159493.57 |
| Total Medical Medicare Payment Amount | 124058.73 |
| Total Medical Medicare Standardized Payment Amount | 131863.87 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 478 |
| Number Of Beneficiaries Age 65 to 74 | 1288 |
| Number Of Beneficiaries Age 75 to 84 | 979 |
| Number Of Beneficiaries Age Greater 84 | 500 |
| Number Of Female Beneficiaries | 2207 |
| Number Of Male Beneficiaries | 1038 |
| Number Of Non Hispanic White Beneficiaries | 2999 |
| Number Of Black or African American Beneficiaries | 147 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 62 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 21 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2619 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 626 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.4044 |