National Provider Identifier [NPI]: |
1427097500 |
Last Name Of The Provider |
GORDON |
First Name Of The Provider |
LEONARD |
Middle Initial Of The Provider |
F |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
8835 GERMANTOWN AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
PHILADELPHIA |
Zip Code Of The Provider |
191182718 |
State Code Of The Provider |
PA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
156 |
Number Of Services |
4620 |
Number Of Medicare Beneficiaries |
2858 |
Total Submitted Charge Amount |
516454 |
Total Medicare Allowed Amount |
131982.97 |
Total Medicare Payment Amount |
98871.04 |
Total Medicare Standardized Payment Amount |
95703.81 |
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 |
156 |
Number Of Medical Services |
4620 |
Number Of Medicare Beneficiaries With Medical Services |
2858 |
Total Medical Submitted Charge Amount |
516454 |
Total Medical Medicare Allowed Amount |
131982.97 |
Total Medical Medicare Payment Amount |
98871.04 |
Total Medical Medicare Standardized Payment Amount |
95703.81 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
508 |
Number Of Beneficiaries Age 65 to 74 |
1005 |
Number Of Beneficiaries Age 75 to 84 |
722 |
Number Of Beneficiaries Age Greater 84 |
623 |
Number Of Female Beneficiaries |
1788 |
Number Of Male Beneficiaries |
1070 |
Number Of Non Hispanic White Beneficiaries |
1704 |
Number Of Black or African American Beneficiaries |
1022 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
74 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
32 |
Number Of Beneficiaries With Medicare Only Entitlement |
2051 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
807 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
27 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
34 |
Percent Of With Chronic Kidney Disease |
35 |
Percent Of With Chronic Obstructive Pulmonary Disease |
24 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
48 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
16 |
Average HCC Risk Score Of Beneficiaries |
1.8397 |