| National Provider Identifier [NPI]: | 1639403645 |
| Last Name Of The Provider | GARDNER |
| First Name Of The Provider | STEVEN |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | PA |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 401 EAST MAIN STREET |
| Street Address 2 Of The Provider | |
| City Of The Provider | JOHNSSON CITY |
| Zip Code Of The Provider | 376014877 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 86 |
| Number Of Services | 615 |
| Number Of Medicare Beneficiaries | 230 |
| Total Submitted Charge Amount | 163549 |
| Total Medicare Allowed Amount | 42337.54 |
| Total Medicare Payment Amount | 31746.12 |
| Total Medicare Standardized Payment Amount | 39686.42 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 92 |
| Number Of Medicare Beneficiaries With Drug Services | 32 |
| Total Drug Submitted ChargeAmount | 5854 |
| Total Drug Medicare AllowedAmount | 3279.6 |
| Total Drug Medicare PaymentAmount | 2557.25 |
| Total Drug Medicare Standardized Payment Amount | 2557.25 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 82 |
| Number Of Medical Services | 523 |
| Number Of Medicare Beneficiaries With Medical Services | 230 |
| Total Medical Submitted Charge Amount | 157695 |
| Total Medical Medicare Allowed Amount | 39057.94 |
| Total Medical Medicare Payment Amount | 29188.87 |
| Total Medical Medicare Standardized Payment Amount | 37129.17 |
| Average Age Of Beneficiaries | 64 |
| Number Of Beneficiaries Age Less65 | 97 |
| Number Of Beneficiaries Age 65 to 74 | 79 |
| Number Of Beneficiaries Age 75 to 84 | 43 |
| Number Of Beneficiaries Age Greater 84 | 11 |
| Number Of Female Beneficiaries | 127 |
| Number Of Male Beneficiaries | 103 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | 157 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 73 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 42 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 62 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.3024 |