| National Provider Identifier [NPI]: | 1013176858 |
| Last Name Of The Provider | GOZANSKY |
| First Name Of The Provider | ELLIOTT |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 22 S GREENE ST |
| Street Address 2 Of The Provider | RADIOLOGY, N2W78 |
| City Of The Provider | BALTIMORE |
| Zip Code Of The Provider | 212011544 |
| 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 | 30 |
| Number Of Services | 5543 |
| Number Of Medicare Beneficiaries | 3048 |
| Total Submitted Charge Amount | 313322 |
| Total Medicare Allowed Amount | 84771.78 |
| Total Medicare Payment Amount | 64479.91 |
| Total Medicare Standardized Payment Amount | 65904.75 |
| 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 | 30 |
| Number Of Medical Services | 5543 |
| Number Of Medicare Beneficiaries With Medical Services | 3048 |
| Total Medical Submitted Charge Amount | 313322 |
| Total Medical Medicare Allowed Amount | 84771.78 |
| Total Medical Medicare Payment Amount | 64479.91 |
| Total Medical Medicare Standardized Payment Amount | 65904.75 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 944 |
| Number Of Beneficiaries Age 65 to 74 | 1024 |
| Number Of Beneficiaries Age 75 to 84 | 655 |
| Number Of Beneficiaries Age Greater 84 | 425 |
| Number Of Female Beneficiaries | 1535 |
| Number Of Male Beneficiaries | 1513 |
| Number Of Non Hispanic White Beneficiaries | 2501 |
| Number Of Black or African American Beneficiaries | 467 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 22 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 40 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2029 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1019 |
| Percent Of With Atrial Fibrillation | 26 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 46 |
| Percent Of With Chronic Kidney Disease | 54 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 41 |
| Percent Of With Depression | 43 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 61 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 2.7087 |