| National Provider Identifier [NPI]: | 1134126840 |
| Last Name Of The Provider | FRIED |
| First Name Of The Provider | GORDON |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 200 PLAZA CT |
| Street Address 2 Of The Provider | SUITE C |
| City Of The Provider | EAST STROUDSBURG |
| Zip Code Of The Provider | 183018259 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 58 |
| Number Of Services | 9384 |
| Number Of Medicare Beneficiaries | 2674 |
| Total Submitted Charge Amount | 1645718 |
| Total Medicare Allowed Amount | 588464.5 |
| Total Medicare Payment Amount | 431802.75 |
| Total Medicare Standardized Payment Amount | 458719.35 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 1381 |
| Number Of Medicare Beneficiaries With Drug Services | 184 |
| Total Drug Submitted ChargeAmount | 41788 |
| Total Drug Medicare AllowedAmount | 4988.87 |
| Total Drug Medicare PaymentAmount | 3906.32 |
| Total Drug Medicare Standardized Payment Amount | 3906.32 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 55 |
| Number Of Medical Services | 8003 |
| Number Of Medicare Beneficiaries With Medical Services | 2674 |
| Total Medical Submitted Charge Amount | 1603930 |
| Total Medical Medicare Allowed Amount | 583475.63 |
| Total Medical Medicare Payment Amount | 427896.43 |
| Total Medical Medicare Standardized Payment Amount | 454813.03 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 447 |
| Number Of Beneficiaries Age 65 to 74 | 921 |
| Number Of Beneficiaries Age 75 to 84 | 824 |
| Number Of Beneficiaries Age Greater 84 | 482 |
| Number Of Female Beneficiaries | 1378 |
| Number Of Male Beneficiaries | 1296 |
| Number Of Non Hispanic White Beneficiaries | 2240 |
| Number Of Black or African American Beneficiaries | 213 |
| Number Of AsianPacific Islander Beneficiaries | 23 |
| Number Of Hispanic Beneficiaries | 171 |
| 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 | 2108 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 566 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 74 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 58 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.7252 |