| National Provider Identifier [NPI]: | 1962482554 |
| Last Name Of The Provider | GORDON |
| First Name Of The Provider | NINA |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 8926 WOODYARD RD |
| Street Address 2 Of The Provider | SUITE 301 |
| City Of The Provider | CLINTON |
| Zip Code Of The Provider | 207354220 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 108 |
| Number Of Services | 5280 |
| Number Of Medicare Beneficiaries | 1391 |
| Total Submitted Charge Amount | 706998.11 |
| Total Medicare Allowed Amount | 242640.38 |
| Total Medicare Payment Amount | 201392.35 |
| Total Medicare Standardized Payment Amount | 195671.04 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 3004 |
| Number Of Medicare Beneficiaries With Drug Services | 55 |
| Total Drug Submitted ChargeAmount | 2253.9 |
| Total Drug Medicare AllowedAmount | 1551.72 |
| Total Drug Medicare PaymentAmount | 1216.56 |
| Total Drug Medicare Standardized Payment Amount | 1216.56 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 105 |
| Number Of Medical Services | 2276 |
| Number Of Medicare Beneficiaries With Medical Services | 1391 |
| Total Medical Submitted Charge Amount | 704744.21 |
| Total Medical Medicare Allowed Amount | 241088.66 |
| Total Medical Medicare Payment Amount | 200175.79 |
| Total Medical Medicare Standardized Payment Amount | 194454.48 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 149 |
| Number Of Beneficiaries Age 65 to 74 | 782 |
| Number Of Beneficiaries Age 75 to 84 | 363 |
| Number Of Beneficiaries Age Greater 84 | 97 |
| Number Of Female Beneficiaries | 1108 |
| Number Of Male Beneficiaries | 283 |
| Number Of Non Hispanic White Beneficiaries | 851 |
| Number Of Black or African American Beneficiaries | 413 |
| Number Of AsianPacific Islander Beneficiaries | 56 |
| Number Of Hispanic Beneficiaries | 51 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1231 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 160 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 24 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.9586 |