| National Provider Identifier [NPI]: | 1659536563 |
| Last Name Of The Provider | GIRTMAN |
| First Name Of The Provider | KEVIN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | PA |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1 SAINT VINCENT CIR |
| Street Address 2 Of The Provider | STE 210 |
| City Of The Provider | LITTLE ROCK |
| Zip Code Of The Provider | 722055405 |
| State Code Of The Provider | AR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 52 |
| Number Of Services | 3799 |
| Number Of Medicare Beneficiaries | 374 |
| Total Submitted Charge Amount | 183342 |
| Total Medicare Allowed Amount | 92256.77 |
| Total Medicare Payment Amount | 64794.71 |
| Total Medicare Standardized Payment Amount | 82492.83 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 743 |
| Number Of Medicare Beneficiaries With Drug Services | 181 |
| Total Drug Submitted ChargeAmount | 9079 |
| Total Drug Medicare AllowedAmount | 3197.45 |
| Total Drug Medicare PaymentAmount | 3029.47 |
| Total Drug Medicare Standardized Payment Amount | 3029.47 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 41 |
| Number Of Medical Services | 3056 |
| Number Of Medicare Beneficiaries With Medical Services | 374 |
| Total Medical Submitted Charge Amount | 174263 |
| Total Medical Medicare Allowed Amount | 89059.32 |
| Total Medical Medicare Payment Amount | 61765.24 |
| Total Medical Medicare Standardized Payment Amount | 79463.36 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 42 |
| Number Of Beneficiaries Age 65 to 74 | 176 |
| Number Of Beneficiaries Age 75 to 84 | 105 |
| Number Of Beneficiaries Age Greater 84 | 51 |
| Number Of Female Beneficiaries | 223 |
| Number Of Male Beneficiaries | 151 |
| Number Of Non Hispanic White Beneficiaries | 361 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 312 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 62 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 11 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 44 |
| Percent Of With Hypertension | 61 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 26 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.9244 |