National Provider Identifier [NPI]: |
1093701658 |
Last Name Of The Provider |
GORDON |
First Name Of The Provider |
ROBERT |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4200 W MEMORIAL RD |
Street Address 2 Of The Provider |
STUITE 805 |
City Of The Provider |
OKLAHOMA CITY |
Zip Code Of The Provider |
731209350 |
State Code Of The Provider |
OK |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pulmonary Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
25 |
Number Of Services |
2137 |
Number Of Medicare Beneficiaries |
801 |
Total Submitted Charge Amount |
308568.94 |
Total Medicare Allowed Amount |
240168.55 |
Total Medicare Payment Amount |
179172.27 |
Total Medicare Standardized Payment Amount |
192727.42 |
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 |
25 |
Number Of Medical Services |
2137 |
Number Of Medicare Beneficiaries With Medical Services |
801 |
Total Medical Submitted Charge Amount |
308568.94 |
Total Medical Medicare Allowed Amount |
240168.55 |
Total Medical Medicare Payment Amount |
179172.27 |
Total Medical Medicare Standardized Payment Amount |
192727.42 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
65 |
Number Of Beneficiaries Age 65 to 74 |
408 |
Number Of Beneficiaries Age 75 to 84 |
274 |
Number Of Beneficiaries Age Greater 84 |
54 |
Number Of Female Beneficiaries |
413 |
Number Of Male Beneficiaries |
388 |
Number Of Non Hispanic White Beneficiaries |
744 |
Number Of Black or African American Beneficiaries |
25 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
20 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
749 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
52 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
18 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
46 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
66 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.0522 |