| National Provider Identifier [NPI]: | 1336197177 |
| Last Name Of The Provider | GORDON |
| First Name Of The Provider | RACHAEL |
| 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 | 8670 WILSHIRE BLVD STE 101 |
| Street Address 2 Of The Provider | |
| City Of The Provider | BEVERLY HILLS |
| Zip Code Of The Provider | 902112930 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 129 |
| Number Of Services | 21228 |
| Number Of Medicare Beneficiaries | 2411 |
| Total Submitted Charge Amount | 5677803.44 |
| Total Medicare Allowed Amount | 879793.26 |
| Total Medicare Payment Amount | 673957.09 |
| Total Medicare Standardized Payment Amount | 607393.63 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 17321 |
| Number Of Medicare Beneficiaries With Drug Services | 593 |
| Total Drug Submitted ChargeAmount | 30130.34 |
| Total Drug Medicare AllowedAmount | 17520.96 |
| Total Drug Medicare PaymentAmount | 13663.15 |
| Total Drug Medicare Standardized Payment Amount | 13663.15 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 121 |
| Number Of Medical Services | 3907 |
| Number Of Medicare Beneficiaries With Medical Services | 2407 |
| Total Medical Submitted Charge Amount | 5647673.1 |
| Total Medical Medicare Allowed Amount | 862272.3 |
| Total Medical Medicare Payment Amount | 660293.94 |
| Total Medical Medicare Standardized Payment Amount | 593730.48 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 197 |
| Number Of Beneficiaries Age 65 to 74 | 1168 |
| Number Of Beneficiaries Age 75 to 84 | 737 |
| Number Of Beneficiaries Age Greater 84 | 309 |
| Number Of Female Beneficiaries | 1421 |
| Number Of Male Beneficiaries | 990 |
| Number Of Non Hispanic White Beneficiaries | 2001 |
| Number Of Black or African American Beneficiaries | 140 |
| Number Of AsianPacific Islander Beneficiaries | 99 |
| Number Of Hispanic Beneficiaries | 92 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2058 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 353 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 58 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 68 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.1202 |