National Provider Identifier [NPI]: |
1992726087 |
Last Name Of The Provider |
GAVIN |
First Name Of The Provider |
SHARON |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1600 SW ARCHER RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
GAINESVILLE |
Zip Code Of The Provider |
326103003 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
23 |
Number Of Services |
439 |
Number Of Medicare Beneficiaries |
218 |
Total Submitted Charge Amount |
122327 |
Total Medicare Allowed Amount |
36604.73 |
Total Medicare Payment Amount |
28649.61 |
Total Medicare Standardized Payment Amount |
28475.58 |
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 |
23 |
Number Of Medical Services |
439 |
Number Of Medicare Beneficiaries With Medical Services |
218 |
Total Medical Submitted Charge Amount |
122327 |
Total Medical Medicare Allowed Amount |
36604.73 |
Total Medical Medicare Payment Amount |
28649.61 |
Total Medical Medicare Standardized Payment Amount |
28475.58 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
76 |
Number Of Beneficiaries Age 65 to 74 |
60 |
Number Of Beneficiaries Age 75 to 84 |
53 |
Number Of Beneficiaries Age Greater 84 |
29 |
Number Of Female Beneficiaries |
112 |
Number Of Male Beneficiaries |
106 |
Number Of Non Hispanic White Beneficiaries |
159 |
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 |
99 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
119 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
36 |
Percent Of With Asthma |
22 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
53 |
Percent Of With Chronic Kidney Disease |
64 |
Percent Of With Chronic Obstructive Pulmonary Disease |
50 |
Percent Of With Depression |
51 |
Percent Of With Diabetes |
48 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
62 |
Percent Of With Osteoporosis |
19 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
17 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
3.0514 |