| National Provider Identifier [NPI]: | 1225049174 |
| Last Name Of The Provider | GANNUCH |
| First Name Of The Provider | GARRET |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1746 COLE BLVD |
| Street Address 2 Of The Provider | SUITE 150 |
| City Of The Provider | LAKEWOOD |
| Zip Code Of The Provider | 804013208 |
| State Code Of The Provider | CO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 149 |
| Number Of Services | 4802 |
| Number Of Medicare Beneficiaries | 2847 |
| Total Submitted Charge Amount | 326540 |
| Total Medicare Allowed Amount | 127345.68 |
| Total Medicare Payment Amount | 95624.47 |
| Total Medicare Standardized Payment Amount | 96475.45 |
| 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 | 149 |
| Number Of Medical Services | 4802 |
| Number Of Medicare Beneficiaries With Medical Services | 2847 |
| Total Medical Submitted Charge Amount | 326540 |
| Total Medical Medicare Allowed Amount | 127345.68 |
| Total Medical Medicare Payment Amount | 95624.47 |
| Total Medical Medicare Standardized Payment Amount | 96475.45 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 538 |
| Number Of Beneficiaries Age 65 to 74 | 1071 |
| Number Of Beneficiaries Age 75 to 84 | 781 |
| Number Of Beneficiaries Age Greater 84 | 457 |
| Number Of Female Beneficiaries | 1648 |
| Number Of Male Beneficiaries | 1199 |
| Number Of Non Hispanic White Beneficiaries | 2197 |
| Number Of Black or African American Beneficiaries | 338 |
| Number Of AsianPacific Islander Beneficiaries | 51 |
| Number Of Hispanic Beneficiaries | 195 |
| Number Of American Indian Alaska Native Beneficiaries | 11 |
| Number Of Beneficiaries With Race Not Else where Classified | 55 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2171 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 676 |
| 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 | 27 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.8368 |