| National Provider Identifier [NPI]: | 1053534925 |
| Last Name Of The Provider | GORDON |
| First Name Of The Provider | EARL |
| 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 | 2001 SANTA MONICA BLVD |
| Street Address 2 Of The Provider | SUITE # 765 - W |
| City Of The Provider | SANTA MONICA |
| Zip Code Of The Provider | 904042102 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nephrology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 36 |
| Number Of Services | 5528 |
| Number Of Medicare Beneficiaries | 860 |
| Total Submitted Charge Amount | 586921.5 |
| Total Medicare Allowed Amount | 486121.35 |
| Total Medicare Payment Amount | 359612.75 |
| Total Medicare Standardized Payment Amount | 335238.71 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 1742 |
| Number Of Medicare Beneficiaries With Drug Services | 241 |
| Total Drug Submitted ChargeAmount | 29022.5 |
| Total Drug Medicare AllowedAmount | 24696.63 |
| Total Drug Medicare PaymentAmount | 20620.37 |
| Total Drug Medicare Standardized Payment Amount | 20620.37 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 31 |
| Number Of Medical Services | 3786 |
| Number Of Medicare Beneficiaries With Medical Services | 860 |
| Total Medical Submitted Charge Amount | 557899 |
| Total Medical Medicare Allowed Amount | 461424.72 |
| Total Medical Medicare Payment Amount | 338992.38 |
| Total Medical Medicare Standardized Payment Amount | 314618.34 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 43 |
| Number Of Beneficiaries Age 65 to 74 | 344 |
| Number Of Beneficiaries Age 75 to 84 | 290 |
| Number Of Beneficiaries Age Greater 84 | 183 |
| Number Of Female Beneficiaries | 446 |
| Number Of Male Beneficiaries | 414 |
| Number Of Non Hispanic White Beneficiaries | 711 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 48 |
| Number Of Hispanic Beneficiaries | 41 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 37 |
| Number Of Beneficiaries With Medicare Only Entitlement | 784 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 76 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.747 |