National Provider Identifier [NPI]: |
1194773200 |
Last Name Of The Provider |
GORSON |
First Name Of The Provider |
DAVID |
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 |
140 HOSPITAL DR |
Street Address 2 Of The Provider |
SUITE 301 |
City Of The Provider |
BENNINGTON |
Zip Code Of The Provider |
052015009 |
State Code Of The Provider |
VT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Endocrinology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
19 |
Number Of Services |
2404 |
Number Of Medicare Beneficiaries |
792 |
Total Submitted Charge Amount |
622046 |
Total Medicare Allowed Amount |
122955.89 |
Total Medicare Payment Amount |
95207.87 |
Total Medicare Standardized Payment Amount |
96207.2 |
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 |
19 |
Number Of Medical Services |
2404 |
Number Of Medicare Beneficiaries With Medical Services |
792 |
Total Medical Submitted Charge Amount |
622046 |
Total Medical Medicare Allowed Amount |
122955.89 |
Total Medical Medicare Payment Amount |
95207.87 |
Total Medical Medicare Standardized Payment Amount |
96207.2 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
105 |
Number Of Beneficiaries Age 65 to 74 |
380 |
Number Of Beneficiaries Age 75 to 84 |
230 |
Number Of Beneficiaries Age Greater 84 |
77 |
Number Of Female Beneficiaries |
639 |
Number Of Male Beneficiaries |
153 |
Number Of Non Hispanic White Beneficiaries |
769 |
Number Of Black or African American Beneficiaries |
|
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 |
640 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
152 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
4 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
42 |
Percent Of With Hypertension |
54 |
Percent Of With Ischemic Heart Disease |
23 |
Percent Of With Osteoporosis |
28 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
32 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
2 |
Average HCC Risk Score Of Beneficiaries |
1.057 |