| National Provider Identifier [NPI]: | 1932123106 |
| Last Name Of The Provider | GORMAN |
| First Name Of The Provider | TIFFANY |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 221 E HACIENDA AVE |
| Street Address 2 Of The Provider | STE B |
| City Of The Provider | CAMPBELL |
| Zip Code Of The Provider | 950086616 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 43 |
| Number Of Services | 617 |
| Number Of Medicare Beneficiaries | 191 |
| Total Submitted Charge Amount | 67365 |
| Total Medicare Allowed Amount | 53689.95 |
| Total Medicare Payment Amount | 39461.25 |
| Total Medicare Standardized Payment Amount | 35536.96 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 43 |
| Number Of Medicare Beneficiaries With Drug Services | 23 |
| Total Drug Submitted ChargeAmount | 2444 |
| Total Drug Medicare AllowedAmount | 1882.34 |
| Total Drug Medicare PaymentAmount | 1638.29 |
| Total Drug Medicare Standardized Payment Amount | 1638.29 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 37 |
| Number Of Medical Services | 574 |
| Number Of Medicare Beneficiaries With Medical Services | 191 |
| Total Medical Submitted Charge Amount | 64921 |
| Total Medical Medicare Allowed Amount | 51807.61 |
| Total Medical Medicare Payment Amount | 37822.96 |
| Total Medical Medicare Standardized Payment Amount | 33898.67 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 132 |
| Number Of Beneficiaries Age 75 to 84 | 42 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 114 |
| Number Of Male Beneficiaries | 77 |
| Number Of Non Hispanic White Beneficiaries | 166 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 191 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 0 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 7 |
| Percent Of With Chronic Kidney Disease | 11 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 7 |
| Percent Of With Diabetes | 19 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 53 |
| Percent Of With Ischemic Heart Disease | 13 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 25 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.6187 |