| National Provider Identifier [NPI]: | 1164535142 |
| Last Name Of The Provider | GORDON |
| First Name Of The Provider | CHARLES |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1814 ROSELAND BLVD |
| Street Address 2 Of The Provider | STE. 200 |
| City Of The Provider | TYLER |
| Zip Code Of The Provider | 757014234 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Neurosurgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 52 |
| Number Of Services | 64014 |
| Number Of Medicare Beneficiaries | 2282 |
| Total Submitted Charge Amount | 4288192.52 |
| Total Medicare Allowed Amount | 1939516.98 |
| Total Medicare Payment Amount | 1798546 |
| Total Medicare Standardized Payment Amount | 1589117.87 |
| 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 | 52 |
| Number Of Medical Services | 64014 |
| Number Of Medicare Beneficiaries With Medical Services | 2282 |
| Total Medical Submitted Charge Amount | 4288192.52 |
| Total Medical Medicare Allowed Amount | 1939516.98 |
| Total Medical Medicare Payment Amount | 1798546 |
| Total Medical Medicare Standardized Payment Amount | 1589117.87 |
| Average Age Of Beneficiaries | 66 |
| Number Of Beneficiaries Age Less65 | 867 |
| Number Of Beneficiaries Age 65 to 74 | 894 |
| Number Of Beneficiaries Age 75 to 84 | 441 |
| Number Of Beneficiaries Age Greater 84 | 80 |
| Number Of Female Beneficiaries | 1381 |
| Number Of Male Beneficiaries | 901 |
| Number Of Non Hispanic White Beneficiaries | 1920 |
| Number Of Black or African American Beneficiaries | 292 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 47 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 12 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1687 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 595 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 37 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.2739 |