| National Provider Identifier [NPI]: | 1609862150 |
| Last Name Of The Provider | GAVIN |
| First Name Of The Provider | MARTIN |
| Middle Initial Of The Provider | F |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 137 W HIGH ST |
| Street Address 2 Of The Provider | SUITE 1A |
| City Of The Provider | ELKTON |
| Zip Code Of The Provider | 219218604 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nephrology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 63 |
| Number Of Services | 8445 |
| Number Of Medicare Beneficiaries | 1009 |
| Total Submitted Charge Amount | 686445 |
| Total Medicare Allowed Amount | 389698.33 |
| Total Medicare Payment Amount | 297711.28 |
| Total Medicare Standardized Payment Amount | 295383.86 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 5211 |
| Number Of Medicare Beneficiaries With Drug Services | 81 |
| Total Drug Submitted ChargeAmount | 31410 |
| Total Drug Medicare AllowedAmount | 26859.57 |
| Total Drug Medicare PaymentAmount | 21177.19 |
| Total Drug Medicare Standardized Payment Amount | 21177.19 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 57 |
| Number Of Medical Services | 3234 |
| Number Of Medicare Beneficiaries With Medical Services | 1009 |
| Total Medical Submitted Charge Amount | 655035 |
| Total Medical Medicare Allowed Amount | 362838.76 |
| Total Medical Medicare Payment Amount | 276534.09 |
| Total Medical Medicare Standardized Payment Amount | 274206.67 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 197 |
| Number Of Beneficiaries Age 65 to 74 | 361 |
| Number Of Beneficiaries Age 75 to 84 | 322 |
| Number Of Beneficiaries Age Greater 84 | 129 |
| Number Of Female Beneficiaries | 454 |
| Number Of Male Beneficiaries | 555 |
| Number Of Non Hispanic White Beneficiaries | 737 |
| Number Of Black or African American Beneficiaries | 229 |
| Number Of AsianPacific Islander Beneficiaries | 16 |
| Number Of Hispanic Beneficiaries | 15 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 784 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 225 |
| Percent Of With Atrial Fibrillation | 29 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 56 |
| Percent Of With Chronic Kidney Disease | 75 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 33 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 61 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 68 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 3.6215 |