| National Provider Identifier [NPI]: | 1649483850 |
| Last Name Of The Provider | GOELITZ |
| First Name Of The Provider | BRIAN |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 488 E VALLEY PKWY |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | ESCONDIDO |
| Zip Code Of The Provider | 920253363 |
| 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 | 261 |
| Number Of Services | 3492 |
| Number Of Medicare Beneficiaries | 1464 |
| Total Submitted Charge Amount | 740097.44 |
| Total Medicare Allowed Amount | 220628.81 |
| Total Medicare Payment Amount | 168467.39 |
| Total Medicare Standardized Payment Amount | 166631.8 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 805 |
| Number Of Medicare Beneficiaries With Drug Services | 18 |
| Total Drug Submitted ChargeAmount | 2128 |
| Total Drug Medicare AllowedAmount | 415.19 |
| Total Drug Medicare PaymentAmount | 324.65 |
| Total Drug Medicare Standardized Payment Amount | 324.65 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 258 |
| Number Of Medical Services | 2687 |
| Number Of Medicare Beneficiaries With Medical Services | 1464 |
| Total Medical Submitted Charge Amount | 737969.44 |
| Total Medical Medicare Allowed Amount | 220213.62 |
| Total Medical Medicare Payment Amount | 168142.74 |
| Total Medical Medicare Standardized Payment Amount | 166307.15 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 216 |
| Number Of Beneficiaries Age 65 to 74 | 414 |
| Number Of Beneficiaries Age 75 to 84 | 426 |
| Number Of Beneficiaries Age Greater 84 | 408 |
| Number Of Female Beneficiaries | 798 |
| Number Of Male Beneficiaries | 666 |
| Number Of Non Hispanic White Beneficiaries | 1119 |
| Number Of Black or African American Beneficiaries | 37 |
| Number Of AsianPacific Islander Beneficiaries | 89 |
| Number Of Hispanic Beneficiaries | 171 |
| Number Of American Indian Alaska Native Beneficiaries | 14 |
| Number Of Beneficiaries With Race Not Else where Classified | 34 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1010 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 454 |
| Percent Of With Atrial Fibrillation | 23 |
| Percent Of With Alzheimers Disease or Dementia | 27 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 41 |
| Percent Of With Chronic Kidney Disease | 45 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 2.3173 |