| National Provider Identifier [NPI]: | 1225004385 |
| Last Name Of The Provider | IBELE |
| First Name Of The Provider | GRETCHEN |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2220 RIVERSIDE AVE S |
| Street Address 2 Of The Provider | MAIL STOP 31700A |
| City Of The Provider | MINNEAPOLIS |
| Zip Code Of The Provider | 554541321 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 96 |
| Number Of Services | 10851 |
| Number Of Medicare Beneficiaries | 111 |
| Total Submitted Charge Amount | 376401 |
| Total Medicare Allowed Amount | 148712.46 |
| Total Medicare Payment Amount | 115473.56 |
| Total Medicare Standardized Payment Amount | 115162.27 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 47 |
| Number Of Drug Services | 10123 |
| Number Of Medicare Beneficiaries With Drug Services | 45 |
| Total Drug Submitted ChargeAmount | 288233 |
| Total Drug Medicare AllowedAmount | 118805.76 |
| Total Drug Medicare PaymentAmount | 93084.85 |
| Total Drug Medicare Standardized Payment Amount | 93084.85 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 49 |
| Number Of Medical Services | 728 |
| Number Of Medicare Beneficiaries With Medical Services | 110 |
| Total Medical Submitted Charge Amount | 88168 |
| Total Medical Medicare Allowed Amount | 29906.7 |
| Total Medical Medicare Payment Amount | 22388.71 |
| Total Medical Medicare Standardized Payment Amount | 22077.42 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 27 |
| Number Of Beneficiaries Age 65 to 74 | 58 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 76 |
| Number Of Male Beneficiaries | 35 |
| Number Of Non Hispanic White Beneficiaries | 87 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 83 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 28 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 32 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 39 |
| Percent Of With Hypertension | 47 |
| Percent Of With Ischemic Heart Disease | 18 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.4378 |