| National Provider Identifier [NPI]: | 1518904747 |
| Last Name Of The Provider | GOBEL |
| First Name Of The Provider | REGINALD |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1055 N CURTIS RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | BOISE |
| Zip Code Of The Provider | 837061309 |
| State Code Of The Provider | ID |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 200 |
| Number Of Services | 7479 |
| Number Of Medicare Beneficiaries | 2266 |
| Total Submitted Charge Amount | 315917.58 |
| Total Medicare Allowed Amount | 129364.62 |
| Total Medicare Payment Amount | 93586.91 |
| Total Medicare Standardized Payment Amount | 100996.68 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 4320 |
| Number Of Medicare Beneficiaries With Drug Services | 46 |
| Total Drug Submitted ChargeAmount | 1050.19 |
| Total Drug Medicare AllowedAmount | 1015.3 |
| Total Drug Medicare PaymentAmount | 770.41 |
| Total Drug Medicare Standardized Payment Amount | 770.41 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 195 |
| Number Of Medical Services | 3159 |
| Number Of Medicare Beneficiaries With Medical Services | 2265 |
| Total Medical Submitted Charge Amount | 314867.39 |
| Total Medical Medicare Allowed Amount | 128349.32 |
| Total Medical Medicare Payment Amount | 92816.5 |
| Total Medical Medicare Standardized Payment Amount | 100226.27 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 482 |
| Number Of Beneficiaries Age 65 to 74 | 788 |
| Number Of Beneficiaries Age 75 to 84 | 637 |
| Number Of Beneficiaries Age Greater 84 | 359 |
| Number Of Female Beneficiaries | 1255 |
| Number Of Male Beneficiaries | 1011 |
| Number Of Non Hispanic White Beneficiaries | 2049 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 144 |
| Number Of American Indian Alaska Native Beneficiaries | 20 |
| Number Of Beneficiaries With Race Not Else where Classified | 27 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1574 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 692 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.5573 |