National Provider Identifier [NPI]: |
1457549156 |
Last Name Of The Provider |
GORDON |
First Name Of The Provider |
ASSAF |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2800 S SHIRLINGTON RD |
Street Address 2 Of The Provider |
STE 102 |
City Of The Provider |
ARLINGTON |
Zip Code Of The Provider |
222063601 |
State Code Of The Provider |
VA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physical Medicine and Rehabilitation |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
61 |
Number Of Services |
8767 |
Number Of Medicare Beneficiaries |
486 |
Total Submitted Charge Amount |
3350578 |
Total Medicare Allowed Amount |
829908.57 |
Total Medicare Payment Amount |
632741.19 |
Total Medicare Standardized Payment Amount |
513989.37 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
11 |
Number Of Drug Services |
5124 |
Number Of Medicare Beneficiaries With Drug Services |
399 |
Total Drug Submitted ChargeAmount |
174233 |
Total Drug Medicare AllowedAmount |
13519.58 |
Total Drug Medicare PaymentAmount |
10301.43 |
Total Drug Medicare Standardized Payment Amount |
10301.43 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
50 |
Number Of Medical Services |
3643 |
Number Of Medicare Beneficiaries With Medical Services |
485 |
Total Medical Submitted Charge Amount |
3176345 |
Total Medical Medicare Allowed Amount |
816388.99 |
Total Medical Medicare Payment Amount |
622439.76 |
Total Medical Medicare Standardized Payment Amount |
503687.94 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
81 |
Number Of Beneficiaries Age 65 to 74 |
192 |
Number Of Beneficiaries Age 75 to 84 |
131 |
Number Of Beneficiaries Age Greater 84 |
82 |
Number Of Female Beneficiaries |
301 |
Number Of Male Beneficiaries |
185 |
Number Of Non Hispanic White Beneficiaries |
352 |
Number Of Black or African American Beneficiaries |
82 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
27 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
13 |
Number Of Beneficiaries With Medicare Only Entitlement |
408 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
78 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
51 |
Percent Of With Hypertension |
64 |
Percent Of With Ischemic Heart Disease |
27 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.1803 |