| National Provider Identifier [NPI]: | 1295707487 |
| Last Name Of The Provider | FORTIN |
| First Name Of The Provider | GREGORY |
| 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 | 5020 W BRISTOL RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | FLINT |
| Zip Code Of The Provider | 485072919 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Vascular Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 124 |
| Number Of Services | 7107 |
| Number Of Medicare Beneficiaries | 749 |
| Total Submitted Charge Amount | 1108135 |
| Total Medicare Allowed Amount | 495271.15 |
| Total Medicare Payment Amount | 386017.57 |
| Total Medicare Standardized Payment Amount | 406940.75 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 5419 |
| Number Of Medicare Beneficiaries With Drug Services | 105 |
| Total Drug Submitted ChargeAmount | 5485.5 |
| Total Drug Medicare AllowedAmount | 1013.83 |
| Total Drug Medicare PaymentAmount | 794.77 |
| Total Drug Medicare Standardized Payment Amount | 794.77 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 122 |
| Number Of Medical Services | 1688 |
| Number Of Medicare Beneficiaries With Medical Services | 749 |
| Total Medical Submitted Charge Amount | 1102649.5 |
| Total Medical Medicare Allowed Amount | 494257.32 |
| Total Medical Medicare Payment Amount | 385222.8 |
| Total Medical Medicare Standardized Payment Amount | 406145.98 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 222 |
| Number Of Beneficiaries Age 65 to 74 | 243 |
| Number Of Beneficiaries Age 75 to 84 | 212 |
| Number Of Beneficiaries Age Greater 84 | 72 |
| Number Of Female Beneficiaries | 361 |
| Number Of Male Beneficiaries | 388 |
| Number Of Non Hispanic White Beneficiaries | 510 |
| Number Of Black or African American Beneficiaries | 210 |
| 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 | 496 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 253 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 24 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 57 |
| Percent Of With Chronic Kidney Disease | 71 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 42 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 64 |
| Percent Of With Hyperlipidemia | 72 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 16 |
| Average HCC Risk Score Of Beneficiaries | 4.7672 |