| National Provider Identifier [NPI]: | 1043200686 |
| Last Name Of The Provider | GORMLEY |
| First Name Of The Provider | TIMOTHY |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 888 SWIFT BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | RICHLAND |
| Zip Code Of The Provider | 993523514 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 215 |
| Number Of Services | 5776 |
| Number Of Medicare Beneficiaries | 3425 |
| Total Submitted Charge Amount | 562016.69 |
| Total Medicare Allowed Amount | 190643.65 |
| Total Medicare Payment Amount | 144254.5 |
| Total Medicare Standardized Payment Amount | 150560.01 |
| 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 | 215 |
| Number Of Medical Services | 5776 |
| Number Of Medicare Beneficiaries With Medical Services | 3425 |
| Total Medical Submitted Charge Amount | 562016.69 |
| Total Medical Medicare Allowed Amount | 190643.65 |
| Total Medical Medicare Payment Amount | 144254.5 |
| Total Medical Medicare Standardized Payment Amount | 150560.01 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 535 |
| Number Of Beneficiaries Age 65 to 74 | 1467 |
| Number Of Beneficiaries Age 75 to 84 | 984 |
| Number Of Beneficiaries Age Greater 84 | 439 |
| Number Of Female Beneficiaries | 2140 |
| Number Of Male Beneficiaries | 1285 |
| Number Of Non Hispanic White Beneficiaries | 3031 |
| Number Of Black or African American Beneficiaries | 40 |
| Number Of AsianPacific Islander Beneficiaries | 48 |
| Number Of Hispanic Beneficiaries | 246 |
| Number Of American Indian Alaska Native Beneficiaries | 17 |
| Number Of Beneficiaries With Race Not Else where Classified | 43 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2769 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 656 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.4313 |