| National Provider Identifier [NPI]: | 1407874290 |
| Last Name Of The Provider | AVERY |
| First Name Of The Provider | GORDON |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1635 N GEORGE MASON DR |
| Street Address 2 Of The Provider | SUITE 310 |
| City Of The Provider | ARLINGTON |
| Zip Code Of The Provider | 222053616 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 110 |
| Number Of Services | 4913 |
| Number Of Medicare Beneficiaries | 845 |
| Total Submitted Charge Amount | 943572.25 |
| Total Medicare Allowed Amount | 329021.34 |
| Total Medicare Payment Amount | 242366.25 |
| Total Medicare Standardized Payment Amount | 210436.13 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 1756 |
| Number Of Medicare Beneficiaries With Drug Services | 433 |
| Total Drug Submitted ChargeAmount | 28425 |
| Total Drug Medicare AllowedAmount | 8374.61 |
| Total Drug Medicare PaymentAmount | 6402.67 |
| Total Drug Medicare Standardized Payment Amount | 6402.67 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 105 |
| Number Of Medical Services | 3157 |
| Number Of Medicare Beneficiaries With Medical Services | 845 |
| Total Medical Submitted Charge Amount | 915147.25 |
| Total Medical Medicare Allowed Amount | 320646.73 |
| Total Medical Medicare Payment Amount | 235963.58 |
| Total Medical Medicare Standardized Payment Amount | 204033.46 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 35 |
| Number Of Beneficiaries Age 65 to 74 | 408 |
| Number Of Beneficiaries Age 75 to 84 | 276 |
| Number Of Beneficiaries Age Greater 84 | 126 |
| Number Of Female Beneficiaries | 522 |
| Number Of Male Beneficiaries | 323 |
| Number Of Non Hispanic White Beneficiaries | 701 |
| Number Of Black or African American Beneficiaries | 48 |
| Number Of AsianPacific Islander Beneficiaries | 31 |
| Number Of Hispanic Beneficiaries | 38 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 27 |
| Number Of Beneficiaries With Medicare Only Entitlement | 795 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 50 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 61 |
| Percent Of With Ischemic Heart Disease | 28 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 70 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 0.9297 |