| National Provider Identifier [NPI]: | 1053381095 |
| Last Name Of The Provider | MIRKIN |
| First Name Of The Provider | GENE |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | DPM |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 10901 CONNECTICUT AVE |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | KENSINGTON |
| Zip Code Of The Provider | 208951645 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 65 |
| Number Of Services | 2260 |
| Number Of Medicare Beneficiaries | 584 |
| Total Submitted Charge Amount | 323807 |
| Total Medicare Allowed Amount | 154504.22 |
| Total Medicare Payment Amount | 109456.29 |
| Total Medicare Standardized Payment Amount | 96510.06 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 51 |
| Number Of Medicare Beneficiaries With Drug Services | 34 |
| Total Drug Submitted ChargeAmount | 478 |
| Total Drug Medicare AllowedAmount | 140.07 |
| Total Drug Medicare PaymentAmount | 104.84 |
| Total Drug Medicare Standardized Payment Amount | 104.84 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 63 |
| Number Of Medical Services | 2209 |
| Number Of Medicare Beneficiaries With Medical Services | 584 |
| Total Medical Submitted Charge Amount | 323329 |
| Total Medical Medicare Allowed Amount | 154364.15 |
| Total Medical Medicare Payment Amount | 109351.45 |
| Total Medical Medicare Standardized Payment Amount | 96405.22 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 24 |
| Number Of Beneficiaries Age 65 to 74 | 253 |
| Number Of Beneficiaries Age 75 to 84 | 199 |
| Number Of Beneficiaries Age Greater 84 | 108 |
| Number Of Female Beneficiaries | 368 |
| Number Of Male Beneficiaries | 216 |
| Number Of Non Hispanic White Beneficiaries | 446 |
| Number Of Black or African American Beneficiaries | 93 |
| Number Of AsianPacific Islander Beneficiaries | 18 |
| Number Of Hispanic Beneficiaries | 12 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 15 |
| Number Of Beneficiaries With Medicare Only Entitlement | 559 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 25 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.1595 |