National Provider Identifier [NPI]: |
1205981867 |
Last Name Of The Provider |
GARDYN |
First Name Of The Provider |
MICHAEL |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
9106 PHILADELPHIA RD |
Street Address 2 Of The Provider |
SUITE #108 |
City Of The Provider |
BALTIMORE |
Zip Code Of The Provider |
212374329 |
State Code Of The Provider |
MD |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Interventional Pain Management |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
38 |
Number Of Services |
2811 |
Number Of Medicare Beneficiaries |
314 |
Total Submitted Charge Amount |
688145 |
Total Medicare Allowed Amount |
282096.88 |
Total Medicare Payment Amount |
206339.68 |
Total Medicare Standardized Payment Amount |
185364.66 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
62 |
Number Of Medicare Beneficiaries With Drug Services |
39 |
Total Drug Submitted ChargeAmount |
5865 |
Total Drug Medicare AllowedAmount |
204.36 |
Total Drug Medicare PaymentAmount |
154.46 |
Total Drug Medicare Standardized Payment Amount |
154.46 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
35 |
Number Of Medical Services |
2749 |
Number Of Medicare Beneficiaries With Medical Services |
314 |
Total Medical Submitted Charge Amount |
682280 |
Total Medical Medicare Allowed Amount |
281892.52 |
Total Medical Medicare Payment Amount |
206185.22 |
Total Medical Medicare Standardized Payment Amount |
185210.2 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
127 |
Number Of Beneficiaries Age 65 to 74 |
93 |
Number Of Beneficiaries Age 75 to 84 |
66 |
Number Of Beneficiaries Age Greater 84 |
28 |
Number Of Female Beneficiaries |
215 |
Number Of Male Beneficiaries |
99 |
Number Of Non Hispanic White Beneficiaries |
280 |
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 |
250 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
64 |
Percent Of With Atrial Fibrillation |
6 |
Percent Of With Alzheimers Disease or Dementia |
4 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
25 |
Percent Of With Depression |
34 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
69 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.446 |