Physician

Michael T. Gambla, M.D.

According to 2025 Medicare claims, Michael Gambla, M.D. (NPI: 1952367641) practices urology in the Kankakee, IL market, with the plurality of this provider's patient population coming from Kankakee, IL. This provider's primary affiliated billing organization is RIVERSIDE HEALTH SYSTEM (NPI: 1417061193; TIN: 36-3167726) and primary practice location at 60901-3493. Gambla is affiliated with the IRCCO (ACO ID: A2619) and CVS Accountable Care Organization, Inc. (ACO ID: D0061), participating under both the MSSP and REACH models.

Gambla's data goes back to 2015 and runs through 2024. For example, in 2024, this provider had 451 traditional Medicare patients, billed 5,813 HCPCS/CPT codes, and received $145,671 in Medicare payments. The top billing code was 52000 (Diagnostic exam of bladder and urethra using an endoscope). Part D data shows 1,854 prescription claims across 549 beneficiaries totaling $170,127 in drug costs, led by Gemtesa (Vibegron). DME data shows 22 claims. Open Payments data shows 46 records totaling $1,243. You can download detailed data with all billing codes (2015-2024). For more recent data, please contact us.

Over the past 10 years, this provider's Medicare Part B carrier billing has moved up and down with repeated peaks and valleys, starting at $194,403 and ending at $145,671. Concurrently, Part D prescription costs have moved up and down with repeated peaks and valleys, starting at $200,391 and ending at $170,127. In contrast, DME billing represents a smaller volume and started with an early spike, then settled into a lower baseline, moving from $1,640 to $1,616.

Part B Carrier Billing Trend

Medicare payment trend, with N of patients and claim lines in the table.

Year	Patients	Clm Lines	Payment
2015	482	7,230	$194,403
2016	646	9,356	$265,784
2017	643	5,745	$241,597
2018	626	5,184	$205,578
2019	625	4,870	$227,813
2020	342	2,919	$98,731
2021	399	5,974	$192,407
2022	473	6,193	$237,204
2023	539	6,122	$234,296
2024	451	5,813	$145,671

Part D Events Trend

Drug cost trend, with N of patients and prescription claims in the table.

Year	Patients	Claims	Drug Cost
2015	415	1,835	$200,391
2016	444	1,776	$180,558
2017	462	1,807	$200,295
2018	418	1,628	$239,669
2019	490	1,814	$238,361
2020	312	1,088	$171,298
2021	337	997	$90,689
2022	437	1,360	$104,650
2023	527	1,718	$175,444
2024	549	1,854	$170,127

DME Billing Trend

Medicare payment trend, with N of patients and DME claim records in the table.

Year	Patients	Claims	Payment
2015	15	176	$30,472
2016	15	128	$18,507
2017	12	43	$6,071
2018	N/R	53	$5,307
2019	N/R	74	$8,339
2020	N/R	87	$33,155
2021	11	35	$10,470
2022	N/R	38	$8,111
2023	12	35	$4,229
2024	N/R	22	$2,428

* / # = suppressed by CMS; 0 = reported zero; N/R = not reported or blank.

Top 5 Part B carrier billing codes in 2024

By total payments.

Code	Description	Patients	Clm Lines	Total Payment
52000	Diagnostic exam of bladder and urethra using an endoscope	78	89	$163
99214	Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	128	160	$90
99213	Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more	206	238	$59
51798	Ultrasound measurement of bladder capacity after voiding	313	455	$7
81003	Automated urinalysis test	312	499	$2

Top 5 Part D drugs in 2024

By total drug costs.

Drug	Generic	Claims	Total Day Supply	Total Drug Cost
Gemtesa	Vibegron	79	4,443	$74,042
Myrbetriq	Mirabegron	66	2,774	$41,661
Oxybutynin Chloride Er	Oxybutynin Chloride	313	23,060	$8,986
Mirabegron Er	Mirabegron	13	690	$8,008
Tamsulosin Hcl	Tamsulosin Hcl	489	35,886	$7,984

Top 5 DME services in 2024

By Total Medicare Payment Amount.

HCPCS Code	HCPCS Description	Supplier Rental Indicator	Total Supplier Beneficiaries	Total Supplier Claims	Total Medicare Payment Amount
A4351	Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each	N	N/R	22	$2,428

Open Payments Summary in 2024

Category	Definition	Records	Total Reported Amount	Top Related Entity
General Payments	Reported payment or transfer-of-value amount.	46	$1,243	Olympus America Inc.
Research Payments	Reported research-related payment or transfer-of-value amount.	0	$0	N/R
Ownership / Investment Interests	Reported value of ownership or investment interests.	0	$0	N/R

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FAQ

What Medicare data is available for Michael T. Gambla, M.D.?

Tedicare shows public-source Medicare data for Michael T. Gambla, M.D. (NPI 1952367641), including provider identity, specialty, market context, Medicare Part B activity, Part D prescribing, DME records, Open Payments where available, billing organization details, and ACO affiliation signals where available. Profile data covers 2015-2024, with current attribution based on 2025 claims where available.

Does Michael T. Gambla, M.D. have ACO affiliation data?

Michael T. Gambla, M.D. is shown with ACO affiliation data for IRCCO (MSSP, ACO ID A2619) and CVS Accountable Care Organization, Inc. (REACH, ACO ID D0061).

What billing organization is linked to Michael T. Gambla, M.D.?

Michael T. Gambla, M.D. is linked to RIVERSIDE HEALTH SYSTEM (billing NPI 1417061193) in the available physician profile data.

Does Michael T. Gambla, M.D. have Open Payments data?

Michael T. Gambla, M.D. has 46 connected Open Payments records in the available 2024 summary data.

Can I download physician-level Medicare data from Tedicare?

Yes. Tedicare provides sample physician export data and paid custom physician data exports for research, planning, outreach, and market analysis. Exports can include physician profile fields, market and specialty context, billing organization details, ACO affiliation signals where available, and Medicare utilization data.