| National Provider Identifier [NPI]: | 1053386771 |
| Last Name Of The Provider | GORENBURG |
| First Name Of The Provider | IDA |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 230 WORCESTER ST |
| Street Address 2 Of The Provider | INTERNAL MEDICINE |
| City Of The Provider | WELLESLEY |
| Zip Code Of The Provider | 024815420 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 93 |
| Number Of Services | 1718 |
| Number Of Medicare Beneficiaries | 539 |
| Total Submitted Charge Amount | 66515.02 |
| Total Medicare Allowed Amount | 47605.61 |
| Total Medicare Payment Amount | 41804.81 |
| Total Medicare Standardized Payment Amount | 41722.24 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 480 |
| Number Of Medicare Beneficiaries With Drug Services | 466 |
| Total Drug Submitted ChargeAmount | 20492.02 |
| Total Drug Medicare AllowedAmount | 9371.11 |
| Total Drug Medicare PaymentAmount | 9180.57 |
| Total Drug Medicare Standardized Payment Amount | 9180.57 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 84 |
| Number Of Medical Services | 1238 |
| Number Of Medicare Beneficiaries With Medical Services | 539 |
| Total Medical Submitted Charge Amount | 46023 |
| Total Medical Medicare Allowed Amount | 38234.5 |
| Total Medical Medicare Payment Amount | 32624.24 |
| Total Medical Medicare Standardized Payment Amount | 32541.67 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 33 |
| Number Of Beneficiaries Age 65 to 74 | 371 |
| Number Of Beneficiaries Age 75 to 84 | 100 |
| Number Of Beneficiaries Age Greater 84 | 35 |
| Number Of Female Beneficiaries | 321 |
| Number Of Male Beneficiaries | 218 |
| Number Of Non Hispanic White Beneficiaries | 470 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 22 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 35 |
| Number Of Beneficiaries With Medicare Only Entitlement | 491 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 48 |
| Percent Of With Atrial Fibrillation | 5 |
| Percent Of With Alzheimers Disease or Dementia | 3 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 6 |
| Percent Of With Chronic Kidney Disease | 10 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 4 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 15 |
| Percent Of With Hyperlipidemia | 28 |
| Percent Of With Hypertension | 35 |
| Percent Of With Ischemic Heart Disease | 14 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 22 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 2 |
| Average HCC Risk Score Of Beneficiaries | 0.7509 |