| National Provider Identifier [NPI]: | 1841283322 |
| Last Name Of The Provider | WELCH |
| First Name Of The Provider | GORDON |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 601 TEXAN TRL |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | CORPUS CHRISTI |
| Zip Code Of The Provider | 784112548 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 63 |
| Number Of Services | 3497 |
| Number Of Medicare Beneficiaries | 519 |
| Total Submitted Charge Amount | 541668 |
| Total Medicare Allowed Amount | 166897.8 |
| Total Medicare Payment Amount | 123359.42 |
| Total Medicare Standardized Payment Amount | 128759.22 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 242 |
| Number Of Medicare Beneficiaries With Drug Services | 28 |
| Total Drug Submitted ChargeAmount | 126640 |
| Total Drug Medicare AllowedAmount | 37133.15 |
| Total Drug Medicare PaymentAmount | 27315.3 |
| Total Drug Medicare Standardized Payment Amount | 27315.3 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 59 |
| Number Of Medical Services | 3255 |
| Number Of Medicare Beneficiaries With Medical Services | 519 |
| Total Medical Submitted Charge Amount | 415028 |
| Total Medical Medicare Allowed Amount | 129764.65 |
| Total Medical Medicare Payment Amount | 96044.12 |
| Total Medical Medicare Standardized Payment Amount | 101443.92 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 26 |
| Number Of Beneficiaries Age 65 to 74 | 220 |
| Number Of Beneficiaries Age 75 to 84 | 183 |
| Number Of Beneficiaries Age Greater 84 | 90 |
| Number Of Female Beneficiaries | 110 |
| Number Of Male Beneficiaries | 409 |
| Number Of Non Hispanic White Beneficiaries | 397 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 106 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 491 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 28 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 20 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.1353 |