| National Provider Identifier [NPI]: | 1700881257 |
| Last Name Of The Provider | GORDON |
| First Name Of The Provider | SLOAN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | DPM |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7737 SOUTHWEST FWY |
| Street Address 2 Of The Provider | STE 500 |
| City Of The Provider | HOUSTON |
| Zip Code Of The Provider | 770741807 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 65 |
| Number Of Services | 1407 |
| Number Of Medicare Beneficiaries | 300 |
| Total Submitted Charge Amount | 281661.25 |
| Total Medicare Allowed Amount | 113262 |
| Total Medicare Payment Amount | 82651.8 |
| Total Medicare Standardized Payment Amount | 84181.65 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 139 |
| Number Of Medicare Beneficiaries With Drug Services | 53 |
| Total Drug Submitted ChargeAmount | 2085 |
| Total Drug Medicare AllowedAmount | 247.91 |
| Total Drug Medicare PaymentAmount | 189.96 |
| Total Drug Medicare Standardized Payment Amount | 189.96 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 64 |
| Number Of Medical Services | 1268 |
| Number Of Medicare Beneficiaries With Medical Services | 300 |
| Total Medical Submitted Charge Amount | 279576.25 |
| Total Medical Medicare Allowed Amount | 113014.09 |
| Total Medical Medicare Payment Amount | 82461.84 |
| Total Medical Medicare Standardized Payment Amount | 83991.69 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 64 |
| Number Of Beneficiaries Age 65 to 74 | 104 |
| Number Of Beneficiaries Age 75 to 84 | 87 |
| Number Of Beneficiaries Age Greater 84 | 45 |
| Number Of Female Beneficiaries | 178 |
| Number Of Male Beneficiaries | 122 |
| Number Of Non Hispanic White Beneficiaries | 134 |
| Number Of Black or African American Beneficiaries | 111 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 40 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 208 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 92 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 22 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 54 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 50 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 2.2797 |