| National Provider Identifier [NPI]: | 1942295027 |
| Last Name Of The Provider | DONALDSON |
| First Name Of The Provider | GORDON |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4103 MAIN ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | ELVERSON |
| Zip Code Of The Provider | 195209378 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 59 |
| Number Of Services | 875 |
| Number Of Medicare Beneficiaries | 154 |
| Total Submitted Charge Amount | 77897 |
| Total Medicare Allowed Amount | 60996.41 |
| Total Medicare Payment Amount | 46133.74 |
| Total Medicare Standardized Payment Amount | 47583.26 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 187 |
| Number Of Medicare Beneficiaries With Drug Services | 118 |
| Total Drug Submitted ChargeAmount | 8103 |
| Total Drug Medicare AllowedAmount | 5875.49 |
| Total Drug Medicare PaymentAmount | 5733.78 |
| Total Drug Medicare Standardized Payment Amount | 5733.78 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 52 |
| Number Of Medical Services | 688 |
| Number Of Medicare Beneficiaries With Medical Services | 153 |
| Total Medical Submitted Charge Amount | 69794 |
| Total Medical Medicare Allowed Amount | 55120.92 |
| Total Medical Medicare Payment Amount | 40399.96 |
| Total Medical Medicare Standardized Payment Amount | 41849.48 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 63 |
| Number Of Beneficiaries Age 75 to 84 | 60 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 85 |
| Number Of Male Beneficiaries | 69 |
| 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 | 154 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 0 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 10 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 10 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 59 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8379 |