| National Provider Identifier [NPI]: | 1235124777 |
| Last Name Of The Provider | GORDON |
| First Name Of The Provider | GREGORY |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 8701 BROADWAY |
| Street Address 2 Of The Provider | |
| City Of The Provider | MERRILLVILLE |
| Zip Code Of The Provider | 464107035 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 24 |
| Number Of Services | 1538 |
| Number Of Medicare Beneficiaries | 806 |
| Total Submitted Charge Amount | 870385 |
| Total Medicare Allowed Amount | 137881.53 |
| Total Medicare Payment Amount | 104956.51 |
| Total Medicare Standardized Payment Amount | 109451.26 |
| 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 | 24 |
| Number Of Medical Services | 1538 |
| Number Of Medicare Beneficiaries With Medical Services | 806 |
| Total Medical Submitted Charge Amount | 870385 |
| Total Medical Medicare Allowed Amount | 137881.53 |
| Total Medical Medicare Payment Amount | 104956.51 |
| Total Medical Medicare Standardized Payment Amount | 109451.26 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 291 |
| Number Of Beneficiaries Age 65 to 74 | 199 |
| Number Of Beneficiaries Age 75 to 84 | 184 |
| Number Of Beneficiaries Age Greater 84 | 132 |
| Number Of Female Beneficiaries | 458 |
| Number Of Male Beneficiaries | 348 |
| Number Of Non Hispanic White Beneficiaries | 297 |
| Number Of Black or African American Beneficiaries | 447 |
| 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 | 410 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 396 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 31 |
| Percent Of With Asthma | 18 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 50 |
| Percent Of With Chronic Kidney Disease | 43 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 39 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 49 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 56 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 24 |
| Percent Of With Stroke | 17 |
| Average HCC Risk Score Of Beneficiaries | 2.5822 |