| National Provider Identifier [NPI]: | 1689724676 |
| Last Name Of The Provider | GORDON-SIMET |
| First Name Of The Provider | JOSETTE |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 12809 W DODGE RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | OMAHA |
| Zip Code Of The Provider | 681542155 |
| State Code Of The Provider | NE |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 45 |
| Number Of Services | 636 |
| Number Of Medicare Beneficiaries | 190 |
| Total Submitted Charge Amount | 50063 |
| Total Medicare Allowed Amount | 23995.76 |
| Total Medicare Payment Amount | 13829.52 |
| Total Medicare Standardized Payment Amount | 15406.43 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 42 |
| Number Of Medicare Beneficiaries With Drug Services | 12 |
| Total Drug Submitted ChargeAmount | 314 |
| Total Drug Medicare AllowedAmount | 146.01 |
| Total Drug Medicare PaymentAmount | 127.85 |
| Total Drug Medicare Standardized Payment Amount | 127.85 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 36 |
| Number Of Medical Services | 594 |
| Number Of Medicare Beneficiaries With Medical Services | 190 |
| Total Medical Submitted Charge Amount | 49749 |
| Total Medical Medicare Allowed Amount | 23849.75 |
| Total Medical Medicare Payment Amount | 13701.67 |
| Total Medical Medicare Standardized Payment Amount | 15278.58 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 55 |
| Number Of Beneficiaries Age 65 to 74 | 67 |
| Number Of Beneficiaries Age 75 to 84 | 43 |
| Number Of Beneficiaries Age Greater 84 | 25 |
| Number Of Female Beneficiaries | 153 |
| Number Of Male Beneficiaries | 37 |
| Number Of Non Hispanic White Beneficiaries | 124 |
| 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 | 127 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 63 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 8 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 43 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 18 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 29 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9803 |