| National Provider Identifier [NPI]: | 1588779607 |
| Last Name Of The Provider | GAVIGAN |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | DPM |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4 BARLOWS LANDING RD |
| Street Address 2 Of The Provider | SUITE #17 |
| City Of The Provider | POCASSET |
| Zip Code Of The Provider | 025591980 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 11 |
| Number Of Services | 6508 |
| Number Of Medicare Beneficiaries | 1736 |
| Total Submitted Charge Amount | 425036 |
| Total Medicare Allowed Amount | 314964.34 |
| Total Medicare Payment Amount | 215412.85 |
| Total Medicare Standardized Payment Amount | 209624.71 |
| 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 | 11 |
| Number Of Medical Services | 6508 |
| Number Of Medicare Beneficiaries With Medical Services | 1736 |
| Total Medical Submitted Charge Amount | 425036 |
| Total Medical Medicare Allowed Amount | 314964.34 |
| Total Medical Medicare Payment Amount | 215412.85 |
| Total Medical Medicare Standardized Payment Amount | 209624.71 |
| Average Age Of Beneficiaries | 80 |
| Number Of Beneficiaries Age Less65 | 128 |
| Number Of Beneficiaries Age 65 to 74 | 334 |
| Number Of Beneficiaries Age 75 to 84 | 617 |
| Number Of Beneficiaries Age Greater 84 | 657 |
| Number Of Female Beneficiaries | 1087 |
| Number Of Male Beneficiaries | 649 |
| Number Of Non Hispanic White Beneficiaries | 1640 |
| Number Of Black or African American Beneficiaries | 27 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 27 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 29 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1160 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 576 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 35 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 13 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.5444 |