| National Provider Identifier [NPI]: | 1790744308 |
| Last Name Of The Provider | ALLEN |
| First Name Of The Provider | GREGORY |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1550 N 115TH |
| Street Address 2 Of The Provider | NORTHWEST HOSPITAL |
| City Of The Provider | SEATTLE |
| Zip Code Of The Provider | 98133 |
| 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 | 148 |
| Number Of Services | 5253 |
| Number Of Medicare Beneficiaries | 2315 |
| Total Submitted Charge Amount | 343796.37 |
| Total Medicare Allowed Amount | 122407.01 |
| Total Medicare Payment Amount | 86910.24 |
| Total Medicare Standardized Payment Amount | 85378.86 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 1203 |
| Number Of Medicare Beneficiaries With Drug Services | 13 |
| Total Drug Submitted ChargeAmount | 252.37 |
| Total Drug Medicare AllowedAmount | 215.51 |
| Total Drug Medicare PaymentAmount | 168.93 |
| Total Drug Medicare Standardized Payment Amount | 168.93 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 145 |
| Number Of Medical Services | 4050 |
| Number Of Medicare Beneficiaries With Medical Services | 2315 |
| Total Medical Submitted Charge Amount | 343544 |
| Total Medical Medicare Allowed Amount | 122191.5 |
| Total Medical Medicare Payment Amount | 86741.31 |
| Total Medical Medicare Standardized Payment Amount | 85209.93 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 319 |
| Number Of Beneficiaries Age 65 to 74 | 704 |
| Number Of Beneficiaries Age 75 to 84 | 690 |
| Number Of Beneficiaries Age Greater 84 | 602 |
| Number Of Female Beneficiaries | 1429 |
| Number Of Male Beneficiaries | 886 |
| Number Of Non Hispanic White Beneficiaries | 2004 |
| Number Of Black or African American Beneficiaries | 71 |
| Number Of AsianPacific Islander Beneficiaries | 127 |
| Number Of Hispanic Beneficiaries | 50 |
| Number Of American Indian Alaska Native Beneficiaries | 20 |
| Number Of Beneficiaries With Race Not Else where Classified | 43 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1755 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 560 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.6356 |