| National Provider Identifier [NPI]: | 1649269499 |
| Last Name Of The Provider | GARDNER |
| First Name Of The Provider | TIMOTHY |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6120 N MAYFAIR ST |
| Street Address 2 Of The Provider | SUITE 101 |
| City Of The Provider | SPOKANE |
| Zip Code Of The Provider | 992081033 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 112 |
| Number Of Services | 9634 |
| Number Of Medicare Beneficiaries | 1352 |
| Total Submitted Charge Amount | 460055.33 |
| Total Medicare Allowed Amount | 197710.91 |
| Total Medicare Payment Amount | 162187.94 |
| Total Medicare Standardized Payment Amount | 163323.57 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 357 |
| Number Of Medicare Beneficiaries With Drug Services | 73 |
| Total Drug Submitted ChargeAmount | 11133 |
| Total Drug Medicare AllowedAmount | 4741.33 |
| Total Drug Medicare PaymentAmount | 3849.88 |
| Total Drug Medicare Standardized Payment Amount | 3849.88 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 101 |
| Number Of Medical Services | 9277 |
| Number Of Medicare Beneficiaries With Medical Services | 1352 |
| Total Medical Submitted Charge Amount | 448922.33 |
| Total Medical Medicare Allowed Amount | 192969.58 |
| Total Medical Medicare Payment Amount | 158338.06 |
| Total Medical Medicare Standardized Payment Amount | 159473.69 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 131 |
| Number Of Beneficiaries Age 65 to 74 | 585 |
| Number Of Beneficiaries Age 75 to 84 | 422 |
| Number Of Beneficiaries Age Greater 84 | 214 |
| Number Of Female Beneficiaries | 880 |
| Number Of Male Beneficiaries | 472 |
| Number Of Non Hispanic White Beneficiaries | 1297 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 13 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 22 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1207 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 145 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 38 |
| Percent Of With Hypertension | 49 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.0614 |