| National Provider Identifier [NPI]: | 1356320568 |
| Last Name Of The Provider | GOSSLEE |
| First Name Of The Provider | JEFFREY |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 725 N ASHLEY RIDGE LOOP |
| Street Address 2 Of The Provider | STE 400 |
| City Of The Provider | SHREVEPORT |
| Zip Code Of The Provider | 711067232 |
| State Code Of The Provider | LA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 34 |
| Number Of Services | 11795 |
| Number Of Medicare Beneficiaries | 1281 |
| Total Submitted Charge Amount | 4600158.5 |
| Total Medicare Allowed Amount | 1693117.75 |
| Total Medicare Payment Amount | 1282291.6 |
| Total Medicare Standardized Payment Amount | 1336805.8 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 3737 |
| Number Of Medicare Beneficiaries With Drug Services | 305 |
| Total Drug Submitted ChargeAmount | 1791779.5 |
| Total Drug Medicare AllowedAmount | 889259.4 |
| Total Drug Medicare PaymentAmount | 693261.23 |
| Total Drug Medicare Standardized Payment Amount | 693261.23 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 27 |
| Number Of Medical Services | 8058 |
| Number Of Medicare Beneficiaries With Medical Services | 1281 |
| Total Medical Submitted Charge Amount | 2808379 |
| Total Medical Medicare Allowed Amount | 803858.35 |
| Total Medical Medicare Payment Amount | 589030.37 |
| Total Medical Medicare Standardized Payment Amount | 643544.57 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 108 |
| Number Of Beneficiaries Age 65 to 74 | 469 |
| Number Of Beneficiaries Age 75 to 84 | 448 |
| Number Of Beneficiaries Age Greater 84 | 256 |
| Number Of Female Beneficiaries | 786 |
| Number Of Male Beneficiaries | 495 |
| Number Of Non Hispanic White Beneficiaries | 1068 |
| Number Of Black or African American Beneficiaries | 180 |
| 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 | 14 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1113 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 168 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.4484 |