| National Provider Identifier [NPI]: | 1336167816 |
| Last Name Of The Provider | GORDON |
| First Name Of The Provider | JEFFERSON |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 100 PROFESSIONAL PL |
| Street Address 2 Of The Provider | SUITE 202 |
| City Of The Provider | CARROLLTON |
| Zip Code Of The Provider | 301173802 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 96 |
| Number Of Services | 6072 |
| Number Of Medicare Beneficiaries | 963 |
| Total Submitted Charge Amount | 518022 |
| Total Medicare Allowed Amount | 297336.21 |
| Total Medicare Payment Amount | 209039.28 |
| Total Medicare Standardized Payment Amount | 225518.19 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 14 |
| Number Of Drug Services | 1545 |
| Number Of Medicare Beneficiaries With Drug Services | 463 |
| Total Drug Submitted ChargeAmount | 27385 |
| Total Drug Medicare AllowedAmount | 6704.17 |
| Total Drug Medicare PaymentAmount | 6020.51 |
| Total Drug Medicare Standardized Payment Amount | 6020.51 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 82 |
| Number Of Medical Services | 4527 |
| Number Of Medicare Beneficiaries With Medical Services | 963 |
| Total Medical Submitted Charge Amount | 490637 |
| Total Medical Medicare Allowed Amount | 290632.04 |
| Total Medical Medicare Payment Amount | 203018.77 |
| Total Medical Medicare Standardized Payment Amount | 219497.68 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 120 |
| Number Of Beneficiaries Age 65 to 74 | 353 |
| Number Of Beneficiaries Age 75 to 84 | 317 |
| Number Of Beneficiaries Age Greater 84 | 173 |
| Number Of Female Beneficiaries | 601 |
| Number Of Male Beneficiaries | 362 |
| Number Of Non Hispanic White Beneficiaries | 875 |
| Number Of Black or African American Beneficiaries | 73 |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 803 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 160 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.3203 |