| National Provider Identifier [NPI]: | 1174562896 |
| Last Name Of The Provider | GORDON |
| First Name Of The Provider | MARILYN |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 817 FEDERAL ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | CAMDEN |
| Zip Code Of The Provider | 081031539 |
| State Code Of The Provider | NJ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 12 |
| Number Of Services | 796 |
| Number Of Medicare Beneficiaries | 357 |
| Total Submitted Charge Amount | 26255 |
| Total Medicare Allowed Amount | 20481.84 |
| Total Medicare Payment Amount | 19534.5 |
| Total Medicare Standardized Payment Amount | 18572.09 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 346 |
| Number Of Medicare Beneficiaries With Drug Services | 288 |
| Total Drug Submitted ChargeAmount | 11325 |
| Total Drug Medicare AllowedAmount | 7877.49 |
| Total Drug Medicare PaymentAmount | 7709.11 |
| Total Drug Medicare Standardized Payment Amount | 7709.11 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 8 |
| Number Of Medical Services | 450 |
| Number Of Medicare Beneficiaries With Medical Services | 349 |
| Total Medical Submitted Charge Amount | 14930 |
| Total Medical Medicare Allowed Amount | 12604.35 |
| Total Medical Medicare Payment Amount | 11825.39 |
| Total Medical Medicare Standardized Payment Amount | 10862.98 |
| Average Age Of Beneficiaries | 66 |
| Number Of Beneficiaries Age Less65 | 122 |
| Number Of Beneficiaries Age 65 to 74 | 154 |
| Number Of Beneficiaries Age 75 to 84 | 63 |
| Number Of Beneficiaries Age Greater 84 | 18 |
| Number Of Female Beneficiaries | 237 |
| Number Of Male Beneficiaries | 120 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | 148 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 177 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 151 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 206 |
| Percent Of With Atrial Fibrillation | 4 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 18 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 54 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 24 |
| Percent Of With Osteoporosis | 3 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.0888 |