| National Provider Identifier [NPI]: | 1912974858 |
| Last Name Of The Provider | GARDNER |
| First Name Of The Provider | PATRICK |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3200 PLEASANT VALLEY RD |
| Street Address 2 Of The Provider | DEPARTMENT OF PATHOLOGY |
| City Of The Provider | WEST BEND |
| Zip Code Of The Provider | 530959274 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pathology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 96 |
| Number Of Services | 49453 |
| Number Of Medicare Beneficiaries | 5706 |
| Total Submitted Charge Amount | 3993216.29 |
| Total Medicare Allowed Amount | 505890.24 |
| Total Medicare Payment Amount | 476622.81 |
| Total Medicare Standardized Payment Amount | 467269.38 |
| 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 | 96 |
| Number Of Medical Services | 49453 |
| Number Of Medicare Beneficiaries With Medical Services | 5706 |
| Total Medical Submitted Charge Amount | 3993216.29 |
| Total Medical Medicare Allowed Amount | 505890.24 |
| Total Medical Medicare Payment Amount | 476622.81 |
| Total Medical Medicare Standardized Payment Amount | 467269.38 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 722 |
| Number Of Beneficiaries Age 65 to 74 | 2581 |
| Number Of Beneficiaries Age 75 to 84 | 1636 |
| Number Of Beneficiaries Age Greater 84 | 767 |
| Number Of Female Beneficiaries | 3308 |
| Number Of Male Beneficiaries | 2398 |
| Number Of Non Hispanic White Beneficiaries | 5503 |
| Number Of Black or African American Beneficiaries | 26 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 34 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 118 |
| Number Of Beneficiaries With Medicare Only Entitlement | 5039 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 667 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 46 |
| Percent Of With Hypertension | 54 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 28 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.9935 |