| National Provider Identifier [NPI]: | 1750659082 |
| Last Name Of The Provider | GARDNER |
| First Name Of The Provider | SARAH |
| Middle Initial Of The Provider | V |
| Credentials Of The Provider | D.O, |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 900 8TH AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | FORT WORTH |
| Zip Code Of The Provider | 761043902 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 36 |
| Number Of Services | 381 |
| Number Of Medicare Beneficiaries | 93 |
| Total Submitted Charge Amount | 50718 |
| Total Medicare Allowed Amount | 27307.29 |
| Total Medicare Payment Amount | 21718.41 |
| Total Medicare Standardized Payment Amount | 21955.1 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 20 |
| Number Of Medicare Beneficiaries With Drug Services | 18 |
| Total Drug Submitted ChargeAmount | 535 |
| Total Drug Medicare AllowedAmount | 196.65 |
| Total Drug Medicare PaymentAmount | 190.12 |
| Total Drug Medicare Standardized Payment Amount | 190.12 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 31 |
| Number Of Medical Services | 361 |
| Number Of Medicare Beneficiaries With Medical Services | 93 |
| Total Medical Submitted Charge Amount | 50183 |
| Total Medical Medicare Allowed Amount | 27110.64 |
| Total Medical Medicare Payment Amount | 21528.29 |
| Total Medical Medicare Standardized Payment Amount | 21764.98 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 23 |
| Number Of Beneficiaries Age 65 to 74 | 35 |
| Number Of Beneficiaries Age 75 to 84 | 23 |
| Number Of Beneficiaries Age Greater 84 | 12 |
| Number Of Female Beneficiaries | 50 |
| Number Of Male Beneficiaries | 43 |
| Number Of Non Hispanic White Beneficiaries | 64 |
| Number Of Black or African American Beneficiaries | 17 |
| 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 | 67 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 26 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 25 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 40 |
| Percent Of With Chronic Kidney Disease | 51 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 42 |
| Percent Of With Diabetes | 52 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 2.2606 |