| National Provider Identifier [NPI]: | 1205886165 |
| Last Name Of The Provider | GAMBETTA |
| First Name Of The Provider | MIGUEL |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 10010 DONALD POWERS DRIVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | MUNSTER |
| Zip Code Of The Provider | 46321 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 54 |
| Number Of Services | 2471 |
| Number Of Medicare Beneficiaries | 313 |
| Total Submitted Charge Amount | 598697 |
| Total Medicare Allowed Amount | 194993.54 |
| Total Medicare Payment Amount | 143581.17 |
| Total Medicare Standardized Payment Amount | 153134.82 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 225 |
| Number Of Medicare Beneficiaries With Drug Services | 66 |
| Total Drug Submitted ChargeAmount | 11589 |
| Total Drug Medicare AllowedAmount | 10949.09 |
| Total Drug Medicare PaymentAmount | 8419.96 |
| Total Drug Medicare Standardized Payment Amount | 8419.96 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 47 |
| Number Of Medical Services | 2246 |
| Number Of Medicare Beneficiaries With Medical Services | 313 |
| Total Medical Submitted Charge Amount | 587108 |
| Total Medical Medicare Allowed Amount | 184044.45 |
| Total Medical Medicare Payment Amount | 135161.21 |
| Total Medical Medicare Standardized Payment Amount | 144714.86 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 16 |
| Number Of Beneficiaries Age 65 to 74 | 97 |
| Number Of Beneficiaries Age 75 to 84 | 120 |
| Number Of Beneficiaries Age Greater 84 | 80 |
| Number Of Female Beneficiaries | 155 |
| Number Of Male Beneficiaries | 158 |
| Number Of Non Hispanic White Beneficiaries | 201 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 92 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 292 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 21 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 52 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 47 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.7479 |