| National Provider Identifier [NPI]: | 1225086747 |
| Last Name Of The Provider | HOLEN |
| First Name Of The Provider | GORDON |
| Middle Initial Of The Provider | N |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2250 DREW ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | CLEARWATER |
| Zip Code Of The Provider | 337653305 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 152 |
| Number Of Services | 2606 |
| Number Of Medicare Beneficiaries | 349 |
| Total Submitted Charge Amount | 677256 |
| Total Medicare Allowed Amount | 231627.24 |
| Total Medicare Payment Amount | 178107.63 |
| Total Medicare Standardized Payment Amount | 192928.18 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 1168 |
| Number Of Medicare Beneficiaries With Drug Services | 113 |
| Total Drug Submitted ChargeAmount | 37366 |
| Total Drug Medicare AllowedAmount | 12272.42 |
| Total Drug Medicare PaymentAmount | 9593.03 |
| Total Drug Medicare Standardized Payment Amount | 9593.03 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 149 |
| Number Of Medical Services | 1438 |
| Number Of Medicare Beneficiaries With Medical Services | 349 |
| Total Medical Submitted Charge Amount | 639890 |
| Total Medical Medicare Allowed Amount | 219354.82 |
| Total Medical Medicare Payment Amount | 168514.6 |
| Total Medical Medicare Standardized Payment Amount | 183335.15 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 101 |
| Number Of Beneficiaries Age 65 to 74 | 124 |
| Number Of Beneficiaries Age 75 to 84 | 77 |
| Number Of Beneficiaries Age Greater 84 | 47 |
| Number Of Female Beneficiaries | 222 |
| Number Of Male Beneficiaries | 127 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 245 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 104 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 71 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.2771 |