| National Provider Identifier [NPI]: | 1346356060 |
| Last Name Of The Provider | GARDNER |
| First Name Of The Provider | CAROL |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | DO |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 905 ROOSEVELT HWY STE 210 |
| Street Address 2 Of The Provider | |
| City Of The Provider | COLCHESTER |
| Zip Code Of The Provider | 054464475 |
| State Code Of The Provider | VT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 21 |
| Number Of Services | 727 |
| Number Of Medicare Beneficiaries | 187 |
| Total Submitted Charge Amount | 105488 |
| Total Medicare Allowed Amount | 63724.48 |
| Total Medicare Payment Amount | 45591.33 |
| Total Medicare Standardized Payment Amount | 46376.78 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 64 |
| Number Of Medicare Beneficiaries With Drug Services | 41 |
| Total Drug Submitted ChargeAmount | 2088 |
| Total Drug Medicare AllowedAmount | 275.93 |
| Total Drug Medicare PaymentAmount | 243.15 |
| Total Drug Medicare Standardized Payment Amount | 243.15 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 19 |
| Number Of Medical Services | 663 |
| Number Of Medicare Beneficiaries With Medical Services | 187 |
| Total Medical Submitted Charge Amount | 103400 |
| Total Medical Medicare Allowed Amount | 63448.55 |
| Total Medical Medicare Payment Amount | 45348.18 |
| Total Medical Medicare Standardized Payment Amount | 46133.63 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 24 |
| Number Of Beneficiaries Age 65 to 74 | 113 |
| Number Of Beneficiaries Age 75 to 84 | 38 |
| Number Of Beneficiaries Age Greater 84 | 12 |
| Number Of Female Beneficiaries | 128 |
| Number Of Male Beneficiaries | 59 |
| Number Of Non Hispanic White Beneficiaries | 176 |
| Number Of Black or African American Beneficiaries | 0 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 0 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 164 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 23 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 6 |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 12 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 39 |
| Percent Of With Ischemic Heart Disease | 16 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 0 |
| Average HCC Risk Score Of Beneficiaries | 0.6366 |