| National Provider Identifier [NPI]: | 1356341408 |
| Last Name Of The Provider | MARTIN |
| First Name Of The Provider | GORDON |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 333 N TEXAS AVE |
| Street Address 2 Of The Provider | SUITE 4200 |
| City Of The Provider | WEBSTER |
| Zip Code Of The Provider | 775984966 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Vascular Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 127 |
| Number Of Services | 1756 |
| Number Of Medicare Beneficiaries | 634 |
| Total Submitted Charge Amount | 1626558 |
| Total Medicare Allowed Amount | 302102.96 |
| Total Medicare Payment Amount | 232568.13 |
| Total Medicare Standardized Payment Amount | 230676.03 |
| 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 | 127 |
| Number Of Medical Services | 1756 |
| Number Of Medicare Beneficiaries With Medical Services | 634 |
| Total Medical Submitted Charge Amount | 1626558 |
| Total Medical Medicare Allowed Amount | 302102.96 |
| Total Medical Medicare Payment Amount | 232568.13 |
| Total Medical Medicare Standardized Payment Amount | 230676.03 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 114 |
| Number Of Beneficiaries Age 65 to 74 | 223 |
| Number Of Beneficiaries Age 75 to 84 | 201 |
| Number Of Beneficiaries Age Greater 84 | 96 |
| Number Of Female Beneficiaries | 345 |
| Number Of Male Beneficiaries | 289 |
| Number Of Non Hispanic White Beneficiaries | 415 |
| Number Of Black or African American Beneficiaries | 96 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 99 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 466 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 168 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 25 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 50 |
| Percent Of With Chronic Kidney Disease | 62 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 56 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 69 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 16 |
| Average HCC Risk Score Of Beneficiaries | 3.5902 |