| National Provider Identifier [NPI]: | 1255311288 |
| Last Name Of The Provider | GIBB |
| First Name Of The Provider | TYLER |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 700 LINCOLN ST |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | KELSO |
| Zip Code Of The Provider | 986261057 |
| 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 | 5991 |
| Number Of Medicare Beneficiaries | 1747 |
| Total Submitted Charge Amount | 598646 |
| Total Medicare Allowed Amount | 161804.41 |
| Total Medicare Payment Amount | 124106.8 |
| Total Medicare Standardized Payment Amount | 126460.25 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 2855 |
| Number Of Medicare Beneficiaries With Drug Services | 37 |
| Total Drug Submitted ChargeAmount | 2282 |
| Total Drug Medicare AllowedAmount | 726.89 |
| Total Drug Medicare PaymentAmount | 545.9 |
| Total Drug Medicare Standardized Payment Amount | 545.9 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 210 |
| Number Of Medical Services | 3136 |
| Number Of Medicare Beneficiaries With Medical Services | 1747 |
| Total Medical Submitted Charge Amount | 596364 |
| Total Medical Medicare Allowed Amount | 161077.52 |
| Total Medical Medicare Payment Amount | 123560.9 |
| Total Medical Medicare Standardized Payment Amount | 125914.35 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 392 |
| Number Of Beneficiaries Age 65 to 74 | 634 |
| Number Of Beneficiaries Age 75 to 84 | 478 |
| Number Of Beneficiaries Age Greater 84 | 243 |
| Number Of Female Beneficiaries | 1123 |
| Number Of Male Beneficiaries | 624 |
| Number Of Non Hispanic White Beneficiaries | 1655 |
| Number Of Black or African American Beneficiaries | 14 |
| Number Of AsianPacific Islander Beneficiaries | 19 |
| Number Of Hispanic Beneficiaries | 26 |
| Number Of American Indian Alaska Native Beneficiaries | 19 |
| Number Of Beneficiaries With Race Not Else where Classified | 14 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1205 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 542 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.5235 |