| National Provider Identifier [NPI]: | 1396943825 |
| Last Name Of The Provider | GARDNER |
| First Name Of The Provider | BRIAN |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | DPM |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 210 W 300 N |
| Street Address 2 Of The Provider | |
| City Of The Provider | ROOSEVELT |
| Zip Code Of The Provider | 840662336 |
| State Code Of The Provider | UT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 49 |
| Number Of Services | 1457 |
| Number Of Medicare Beneficiaries | 356 |
| Total Submitted Charge Amount | 161583.25 |
| Total Medicare Allowed Amount | 87071.46 |
| Total Medicare Payment Amount | 61307.66 |
| Total Medicare Standardized Payment Amount | 65567.98 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 233 |
| Number Of Medicare Beneficiaries With Drug Services | 32 |
| Total Drug Submitted ChargeAmount | 3884 |
| Total Drug Medicare AllowedAmount | 2656.45 |
| Total Drug Medicare PaymentAmount | 2072.69 |
| Total Drug Medicare Standardized Payment Amount | 2072.69 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 45 |
| Number Of Medical Services | 1224 |
| Number Of Medicare Beneficiaries With Medical Services | 356 |
| Total Medical Submitted Charge Amount | 157699.25 |
| Total Medical Medicare Allowed Amount | 84415.01 |
| Total Medical Medicare Payment Amount | 59234.97 |
| Total Medical Medicare Standardized Payment Amount | 63495.29 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 42 |
| Number Of Beneficiaries Age 65 to 74 | 114 |
| Number Of Beneficiaries Age 75 to 84 | 113 |
| Number Of Beneficiaries Age Greater 84 | 87 |
| Number Of Female Beneficiaries | 220 |
| Number Of Male Beneficiaries | 136 |
| Number Of Non Hispanic White Beneficiaries | 326 |
| Number Of Black or African American Beneficiaries | 0 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 15 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 260 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 96 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 25 |
| Percent Of With Asthma | 3 |
| Percent Of With Cancer | 5 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 46 |
| Percent Of With Hyperlipidemia | 23 |
| Percent Of With Hypertension | 49 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.3061 |