| National Provider Identifier [NPI]: | 1538265434 |
| Last Name Of The Provider | BAUMGARDNER |
| First Name Of The Provider | GAVIN |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7652 SAWMILL RD |
| Street Address 2 Of The Provider | SUITE 321 |
| City Of The Provider | DUBLIN |
| Zip Code Of The Provider | 430169296 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 30 |
| Number Of Services | 1780 |
| Number Of Medicare Beneficiaries | 888 |
| Total Submitted Charge Amount | 338298.1 |
| Total Medicare Allowed Amount | 180515.98 |
| Total Medicare Payment Amount | 137421.97 |
| Total Medicare Standardized Payment Amount | 141904.77 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 30 |
| Number Of Medical Services | 1780 |
| Number Of Medicare Beneficiaries With Medical Services | 888 |
| Total Medical Submitted Charge Amount | 338298.1 |
| Total Medical Medicare Allowed Amount | 180515.98 |
| Total Medical Medicare Payment Amount | 137421.97 |
| Total Medical Medicare Standardized Payment Amount | 141904.77 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 294 |
| Number Of Beneficiaries Age 65 to 74 | 236 |
| Number Of Beneficiaries Age 75 to 84 | 205 |
| Number Of Beneficiaries Age Greater 84 | 153 |
| Number Of Female Beneficiaries | 536 |
| Number Of Male Beneficiaries | 352 |
| Number Of Non Hispanic White Beneficiaries | 739 |
| Number Of Black or African American Beneficiaries | 123 |
| 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 | 413 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 475 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 30 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 40 |
| Percent Of With Chronic Kidney Disease | 49 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 35 |
| Percent Of With Depression | 49 |
| Percent Of With Diabetes | 49 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 53 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 15 |
| Percent Of With Stroke | 17 |
| Average HCC Risk Score Of Beneficiaries | 2.3324 |