| National Provider Identifier [NPI]: | 1952348153 |
| Last Name Of The Provider | GORDON |
| First Name Of The Provider | BRUCE |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 8150 N CENTRAL EXPY |
| Street Address 2 Of The Provider | SUITE M1001 |
| City Of The Provider | DALLAS |
| Zip Code Of The Provider | 752061815 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 94 |
| Number Of Services | 4275 |
| Number Of Medicare Beneficiaries | 902 |
| Total Submitted Charge Amount | 1861316.96 |
| Total Medicare Allowed Amount | 497557.65 |
| Total Medicare Payment Amount | 369631.93 |
| Total Medicare Standardized Payment Amount | 395868.23 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 558 |
| Number Of Medicare Beneficiaries With Drug Services | 141 |
| Total Drug Submitted ChargeAmount | 37586.96 |
| Total Drug Medicare AllowedAmount | 28526.91 |
| Total Drug Medicare PaymentAmount | 22129.87 |
| Total Drug Medicare Standardized Payment Amount | 22129.87 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 92 |
| Number Of Medical Services | 3717 |
| Number Of Medicare Beneficiaries With Medical Services | 902 |
| Total Medical Submitted Charge Amount | 1823730 |
| Total Medical Medicare Allowed Amount | 469030.74 |
| Total Medical Medicare Payment Amount | 347502.06 |
| Total Medical Medicare Standardized Payment Amount | 373738.36 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 60 |
| Number Of Beneficiaries Age 65 to 74 | 406 |
| Number Of Beneficiaries Age 75 to 84 | 323 |
| Number Of Beneficiaries Age Greater 84 | 113 |
| Number Of Female Beneficiaries | 456 |
| Number Of Male Beneficiaries | 446 |
| Number Of Non Hispanic White Beneficiaries | 849 |
| Number Of Black or African American Beneficiaries | 11 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 24 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 798 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 104 |
| Percent Of With Atrial Fibrillation | 26 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 43 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.4871 |