| National Provider Identifier [NPI]: | 1063408391 |
| Last Name Of The Provider | GAVIN |
| First Name Of The Provider | MATTHEW |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 224D CORNWALL ST NW |
| Street Address 2 Of The Provider | SUITE 204 |
| City Of The Provider | LEESBURG |
| Zip Code Of The Provider | 201762700 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 103 |
| Number Of Services | 1860 |
| Number Of Medicare Beneficiaries | 387 |
| Total Submitted Charge Amount | 538382 |
| Total Medicare Allowed Amount | 178225.7 |
| Total Medicare Payment Amount | 131820.59 |
| Total Medicare Standardized Payment Amount | 137144.65 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 322 |
| Number Of Medicare Beneficiaries With Drug Services | 65 |
| Total Drug Submitted ChargeAmount | 91577 |
| Total Drug Medicare AllowedAmount | 30764.48 |
| Total Drug Medicare PaymentAmount | 23920.74 |
| Total Drug Medicare Standardized Payment Amount | 23920.74 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 99 |
| Number Of Medical Services | 1538 |
| Number Of Medicare Beneficiaries With Medical Services | 387 |
| Total Medical Submitted Charge Amount | 446805 |
| Total Medical Medicare Allowed Amount | 147461.22 |
| Total Medical Medicare Payment Amount | 107899.85 |
| Total Medical Medicare Standardized Payment Amount | 113223.91 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 24 |
| Number Of Beneficiaries Age 65 to 74 | 194 |
| Number Of Beneficiaries Age 75 to 84 | 113 |
| Number Of Beneficiaries Age Greater 84 | 56 |
| Number Of Female Beneficiaries | 251 |
| Number Of Male Beneficiaries | 136 |
| Number Of Non Hispanic White Beneficiaries | 335 |
| Number Of Black or African American Beneficiaries | 24 |
| Number Of AsianPacific Islander Beneficiaries | 15 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 342 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 45 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 60 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.0856 |