National Provider Identifier [NPI]: |
1013957166 |
Last Name Of The Provider |
GARVIN |
First Name Of The Provider |
MICHAEL |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
DPM |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1791 SE PORT ST LUCIE BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
PORT ST LUCIE |
Zip Code Of The Provider |
349525479 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Podiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
62 |
Number Of Services |
4595 |
Number Of Medicare Beneficiaries |
675 |
Total Submitted Charge Amount |
347779.15 |
Total Medicare Allowed Amount |
285157.13 |
Total Medicare Payment Amount |
207611.42 |
Total Medicare Standardized Payment Amount |
197841.14 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
1 |
Number Of Drug Services |
179 |
Number Of Medicare Beneficiaries With Drug Services |
86 |
Total Drug Submitted ChargeAmount |
1790 |
Total Drug Medicare AllowedAmount |
1022.97 |
Total Drug Medicare PaymentAmount |
749.47 |
Total Drug Medicare Standardized Payment Amount |
749.47 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
61 |
Number Of Medical Services |
4416 |
Number Of Medicare Beneficiaries With Medical Services |
675 |
Total Medical Submitted Charge Amount |
345989.15 |
Total Medical Medicare Allowed Amount |
284134.16 |
Total Medical Medicare Payment Amount |
206861.95 |
Total Medical Medicare Standardized Payment Amount |
197091.67 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
57 |
Number Of Beneficiaries Age 65 to 74 |
244 |
Number Of Beneficiaries Age 75 to 84 |
228 |
Number Of Beneficiaries Age Greater 84 |
146 |
Number Of Female Beneficiaries |
364 |
Number Of Male Beneficiaries |
311 |
Number Of Non Hispanic White Beneficiaries |
574 |
Number Of Black or African American Beneficiaries |
53 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
29 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
562 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
113 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
19 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
20 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
46 |
Percent Of With Hyperlipidemia |
70 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
49 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
51 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.4991 |