| National Provider Identifier [NPI]: | 1760452312 |
| Last Name Of The Provider | BEAN |
| First Name Of The Provider | GARY |
| Middle Initial Of The Provider | O |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4414 LAKE BOONE TRAIL |
| Street Address 2 Of The Provider | SUITE 502 |
| City Of The Provider | RALEIGH |
| Zip Code Of The Provider | 276077514 |
| State Code Of The Provider | NC |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 79 |
| Number Of Services | 4813 |
| Number Of Medicare Beneficiaries | 462 |
| Total Submitted Charge Amount | 312441 |
| Total Medicare Allowed Amount | 191639.87 |
| Total Medicare Payment Amount | 149983.97 |
| Total Medicare Standardized Payment Amount | 157952.72 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 17 |
| Number Of Drug Services | 472 |
| Number Of Medicare Beneficiaries With Drug Services | 249 |
| Total Drug Submitted ChargeAmount | 42474 |
| Total Drug Medicare AllowedAmount | 36989.19 |
| Total Drug Medicare PaymentAmount | 33336.01 |
| Total Drug Medicare Standardized Payment Amount | 33336.01 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 62 |
| Number Of Medical Services | 4341 |
| Number Of Medicare Beneficiaries With Medical Services | 462 |
| Total Medical Submitted Charge Amount | 269967 |
| Total Medical Medicare Allowed Amount | 154650.68 |
| Total Medical Medicare Payment Amount | 116647.96 |
| Total Medical Medicare Standardized Payment Amount | 124616.71 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 31 |
| Number Of Beneficiaries Age 65 to 74 | 296 |
| Number Of Beneficiaries Age 75 to 84 | 113 |
| Number Of Beneficiaries Age Greater 84 | 22 |
| Number Of Female Beneficiaries | 237 |
| Number Of Male Beneficiaries | 225 |
| Number Of Non Hispanic White Beneficiaries | 423 |
| Number Of Black or African American Beneficiaries | 27 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 0 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 449 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 13 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 8 |
| Percent Of With Chronic Kidney Disease | 8 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 4 |
| Percent Of With Depression | 9 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 35 |
| Percent Of With Hypertension | 36 |
| Percent Of With Ischemic Heart Disease | 22 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 23 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.7744 |