| National Provider Identifier [NPI]: | 1871589515 |
| Last Name Of The Provider | GARRETT |
| First Name Of The Provider | HARRY |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 100 S MAIN ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | WEST SALEM |
| Zip Code Of The Provider | 624761202 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 91 |
| Number Of Services | 6245 |
| Number Of Medicare Beneficiaries | 1131 |
| Total Submitted Charge Amount | 296923.12 |
| Total Medicare Allowed Amount | 225992.22 |
| Total Medicare Payment Amount | 162235.19 |
| Total Medicare Standardized Payment Amount | 161171.64 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 208 |
| Number Of Medicare Beneficiaries With Drug Services | 125 |
| Total Drug Submitted ChargeAmount | 6874 |
| Total Drug Medicare AllowedAmount | 4437.4 |
| Total Drug Medicare PaymentAmount | 4275.24 |
| Total Drug Medicare Standardized Payment Amount | 4275.24 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 82 |
| Number Of Medical Services | 6037 |
| Number Of Medicare Beneficiaries With Medical Services | 1131 |
| Total Medical Submitted Charge Amount | 290049.12 |
| Total Medical Medicare Allowed Amount | 221554.82 |
| Total Medical Medicare Payment Amount | 157959.95 |
| Total Medical Medicare Standardized Payment Amount | 156896.4 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 211 |
| Number Of Beneficiaries Age 65 to 74 | 458 |
| Number Of Beneficiaries Age 75 to 84 | 297 |
| Number Of Beneficiaries Age Greater 84 | 165 |
| Number Of Female Beneficiaries | 641 |
| Number Of Male Beneficiaries | 490 |
| Number Of Non Hispanic White Beneficiaries | 1110 |
| 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 | 844 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 287 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 3 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 44 |
| Percent Of With Hypertension | 55 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.0219 |