| National Provider Identifier [NPI]: | 1730106352 |
| Last Name Of The Provider | GORDON |
| First Name Of The Provider | RICHARD |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4271 HEMPSTEAD TPKE |
| Street Address 2 Of The Provider | SUITE 1 |
| City Of The Provider | BETHPAGE |
| Zip Code Of The Provider | 11714 |
| State Code Of The Provider | NY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pulmonary Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 37 |
| Number Of Services | 2854 |
| Number Of Medicare Beneficiaries | 623 |
| Total Submitted Charge Amount | 613820 |
| Total Medicare Allowed Amount | 294967.36 |
| Total Medicare Payment Amount | 223776.57 |
| Total Medicare Standardized Payment Amount | 195557.42 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 34 |
| Number Of Medicare Beneficiaries With Drug Services | 30 |
| Total Drug Submitted ChargeAmount | 1455 |
| Total Drug Medicare AllowedAmount | 523.64 |
| Total Drug Medicare PaymentAmount | 512.96 |
| Total Drug Medicare Standardized Payment Amount | 512.96 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 33 |
| Number Of Medical Services | 2820 |
| Number Of Medicare Beneficiaries With Medical Services | 623 |
| Total Medical Submitted Charge Amount | 612365 |
| Total Medical Medicare Allowed Amount | 294443.72 |
| Total Medical Medicare Payment Amount | 223263.61 |
| Total Medical Medicare Standardized Payment Amount | 195044.46 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 71 |
| Number Of Beneficiaries Age 65 to 74 | 172 |
| Number Of Beneficiaries Age 75 to 84 | 206 |
| Number Of Beneficiaries Age Greater 84 | 174 |
| Number Of Female Beneficiaries | 357 |
| Number Of Male Beneficiaries | 266 |
| Number Of Non Hispanic White Beneficiaries | 556 |
| Number Of Black or African American Beneficiaries | 36 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 16 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 475 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 148 |
| Percent Of With Atrial Fibrillation | 30 |
| Percent Of With Alzheimers Disease or Dementia | 27 |
| Percent Of With Asthma | 28 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 61 |
| Percent Of With Chronic Kidney Disease | 43 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 59 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 49 |
| Percent Of With Hyperlipidemia | 73 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 2.3143 |