| National Provider Identifier [NPI]: | 1598837957 |
| Last Name Of The Provider | BLICK |
| First Name Of The Provider | GARY |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 618 WEST AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | NORWALK |
| Zip Code Of The Provider | 068504008 |
| State Code Of The Provider | CT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 51 |
| Number Of Services | 38762.5 |
| Number Of Medicare Beneficiaries | 102 |
| Total Submitted Charge Amount | 377999 |
| Total Medicare Allowed Amount | 183135.51 |
| Total Medicare Payment Amount | 140805.65 |
| Total Medicare Standardized Payment Amount | 118700.54 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 14 |
| Number Of Drug Services | 186 |
| Number Of Medicare Beneficiaries With Drug Services | 38 |
| Total Drug Submitted ChargeAmount | 4775 |
| Total Drug Medicare AllowedAmount | 2688.53 |
| Total Drug Medicare PaymentAmount | 2504.22 |
| Total Drug Medicare Standardized Payment Amount | 2504.22 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 37 |
| Number Of Medical Services | 38576.5 |
| Number Of Medicare Beneficiaries With Medical Services | 102 |
| Total Medical Submitted Charge Amount | 373224 |
| Total Medical Medicare Allowed Amount | 180446.98 |
| Total Medical Medicare Payment Amount | 138301.43 |
| Total Medical Medicare Standardized Payment Amount | 116196.32 |
| Average Age Of Beneficiaries | 60 |
| Number Of Beneficiaries Age Less65 | 58 |
| Number Of Beneficiaries Age 65 to 74 | |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 11 |
| Number Of Male Beneficiaries | 91 |
| Number Of Non Hispanic White Beneficiaries | 85 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| 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 | 59 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 43 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 51 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 33 |
| Percent Of With Ischemic Heart Disease | 28 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 22 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.3478 |