| National Provider Identifier [NPI]: | 1336244409 |
| Last Name Of The Provider | GARDNER |
| First Name Of The Provider | RODDY |
| 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 | 910 S PRIEST DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | TEMPE |
| Zip Code Of The Provider | 852815233 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | General Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 22 |
| Number Of Services | 628 |
| Number Of Medicare Beneficiaries | 146 |
| Total Submitted Charge Amount | 45620.29 |
| Total Medicare Allowed Amount | 41786.24 |
| Total Medicare Payment Amount | 26646.02 |
| Total Medicare Standardized Payment Amount | 28664.36 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 39 |
| Number Of Medicare Beneficiaries With Drug Services | 17 |
| Total Drug Submitted ChargeAmount | 400 |
| Total Drug Medicare AllowedAmount | 129.53 |
| Total Drug Medicare PaymentAmount | 74.13 |
| Total Drug Medicare Standardized Payment Amount | 74.13 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 16 |
| Number Of Medical Services | 589 |
| Number Of Medicare Beneficiaries With Medical Services | 146 |
| Total Medical Submitted Charge Amount | 45220.29 |
| Total Medical Medicare Allowed Amount | 41656.71 |
| Total Medical Medicare Payment Amount | 26571.89 |
| Total Medical Medicare Standardized Payment Amount | 28590.23 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 69 |
| Number Of Beneficiaries Age 75 to 84 | 36 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 78 |
| Number Of Male Beneficiaries | 68 |
| Number Of Non Hispanic White Beneficiaries | 82 |
| Number Of Black or African American Beneficiaries | 18 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 35 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 112 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 34 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 19 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.2766 |