| National Provider Identifier [NPI]: | 1770558686 |
| Last Name Of The Provider | GOLLER |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1000 TRANCAS ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | NAPA |
| Zip Code Of The Provider | 945582906 |
| 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 | 200 |
| Number Of Services | 4382 |
| Number Of Medicare Beneficiaries | 2503 |
| Total Submitted Charge Amount | 666644.02 |
| Total Medicare Allowed Amount | 147114.28 |
| Total Medicare Payment Amount | 115496.78 |
| Total Medicare Standardized Payment Amount | 107956.72 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 200 |
| Number Of Medical Services | 4382 |
| Number Of Medicare Beneficiaries With Medical Services | 2503 |
| Total Medical Submitted Charge Amount | 666644.02 |
| Total Medical Medicare Allowed Amount | 147114.28 |
| Total Medical Medicare Payment Amount | 115496.78 |
| Total Medical Medicare Standardized Payment Amount | 107956.72 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 261 |
| Number Of Beneficiaries Age 65 to 74 | 925 |
| Number Of Beneficiaries Age 75 to 84 | 767 |
| Number Of Beneficiaries Age Greater 84 | 550 |
| Number Of Female Beneficiaries | 1445 |
| Number Of Male Beneficiaries | 1058 |
| Number Of Non Hispanic White Beneficiaries | 2172 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 56 |
| Number Of Hispanic Beneficiaries | 205 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 35 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2035 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 468 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.5553 |