National Provider Identifier [NPI]: |
1831179233 |
Last Name Of The Provider |
GARDNER |
First Name Of The Provider |
EDWARD |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
10201 KANIS RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
LITTLE ROCK |
Zip Code Of The Provider |
722056203 |
State Code Of The Provider |
AR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Otolaryngology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
63 |
Number Of Services |
1262 |
Number Of Medicare Beneficiaries |
646 |
Total Submitted Charge Amount |
299025 |
Total Medicare Allowed Amount |
124874.46 |
Total Medicare Payment Amount |
89280.43 |
Total Medicare Standardized Payment Amount |
99193.42 |
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 |
63 |
Number Of Medical Services |
1262 |
Number Of Medicare Beneficiaries With Medical Services |
646 |
Total Medical Submitted Charge Amount |
299025 |
Total Medical Medicare Allowed Amount |
124874.46 |
Total Medical Medicare Payment Amount |
89280.43 |
Total Medical Medicare Standardized Payment Amount |
99193.42 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
83 |
Number Of Beneficiaries Age 65 to 74 |
293 |
Number Of Beneficiaries Age 75 to 84 |
196 |
Number Of Beneficiaries Age Greater 84 |
74 |
Number Of Female Beneficiaries |
386 |
Number Of Male Beneficiaries |
260 |
Number Of Non Hispanic White Beneficiaries |
603 |
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 |
575 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
71 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
66 |
Percent Of With Ischemic Heart Disease |
38 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.0252 |