| National Provider Identifier [NPI]: | 1407849722 |
| Last Name Of The Provider | GORDON |
| First Name Of The Provider | STEPHANIE |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2750 OWENS RD SW |
| Street Address 2 Of The Provider | SUITE A |
| City Of The Provider | CONYERS |
| Zip Code Of The Provider | 300943991 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Obstetrics/Gynecology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 83 |
| Number Of Services | 2712 |
| Number Of Medicare Beneficiaries | 488 |
| Total Submitted Charge Amount | 479121 |
| Total Medicare Allowed Amount | 193784.15 |
| Total Medicare Payment Amount | 145961.28 |
| Total Medicare Standardized Payment Amount | 145931.8 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 768 |
| Number Of Medicare Beneficiaries With Drug Services | 39 |
| Total Drug Submitted ChargeAmount | 34367 |
| Total Drug Medicare AllowedAmount | 7554.69 |
| Total Drug Medicare PaymentAmount | 5682.3 |
| Total Drug Medicare Standardized Payment Amount | 5682.3 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 76 |
| Number Of Medical Services | 1944 |
| Number Of Medicare Beneficiaries With Medical Services | 487 |
| Total Medical Submitted Charge Amount | 444754 |
| Total Medical Medicare Allowed Amount | 186229.46 |
| Total Medical Medicare Payment Amount | 140278.98 |
| Total Medical Medicare Standardized Payment Amount | 140249.5 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 88 |
| Number Of Beneficiaries Age 65 to 74 | 261 |
| Number Of Beneficiaries Age 75 to 84 | 110 |
| Number Of Beneficiaries Age Greater 84 | 29 |
| Number Of Female Beneficiaries | 488 |
| Number Of Male Beneficiaries | 0 |
| Number Of Non Hispanic White Beneficiaries | 384 |
| Number Of Black or African American Beneficiaries | 89 |
| 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 | |
| Number Of Beneficiaries With Medicare Only Entitlement | 425 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 63 |
| Percent Of With Atrial Fibrillation | 4 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 8 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 17 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.9038 |