| National Provider Identifier [NPI]: | 1982609665 |
| Last Name Of The Provider | GORDON |
| First Name Of The Provider | LAWRENCE |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6005 PARK AVE |
| Street Address 2 Of The Provider | STE 624B |
| City Of The Provider | MEMPHIS |
| Zip Code Of The Provider | 381195221 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 45 |
| Number Of Services | 11631 |
| Number Of Medicare Beneficiaries | 1379 |
| Total Submitted Charge Amount | 3816368.98 |
| Total Medicare Allowed Amount | 1860068.33 |
| Total Medicare Payment Amount | 1398868.59 |
| Total Medicare Standardized Payment Amount | 1444897.18 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 3747 |
| Number Of Medicare Beneficiaries With Drug Services | 486 |
| Total Drug Submitted ChargeAmount | 1169262.76 |
| Total Drug Medicare AllowedAmount | 1129878.56 |
| Total Drug Medicare PaymentAmount | 862540.03 |
| Total Drug Medicare Standardized Payment Amount | 862540.03 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 36 |
| Number Of Medical Services | 7884 |
| Number Of Medicare Beneficiaries With Medical Services | 1379 |
| Total Medical Submitted Charge Amount | 2647106.22 |
| Total Medical Medicare Allowed Amount | 730189.77 |
| Total Medical Medicare Payment Amount | 536328.56 |
| Total Medical Medicare Standardized Payment Amount | 582357.15 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 118 |
| Number Of Beneficiaries Age 65 to 74 | 497 |
| Number Of Beneficiaries Age 75 to 84 | 494 |
| Number Of Beneficiaries Age Greater 84 | 270 |
| Number Of Female Beneficiaries | 832 |
| Number Of Male Beneficiaries | 547 |
| Number Of Non Hispanic White Beneficiaries | 1227 |
| Number Of Black or African American Beneficiaries | 129 |
| 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 | 12 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1157 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 222 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 47 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.5454 |