| National Provider Identifier [NPI]: | 1912990342 |
| Last Name Of The Provider | GONZALEZ |
| First Name Of The Provider | JOSE |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 420 SOUTH JACKSON STREET |
| Street Address 2 Of The Provider | |
| City Of The Provider | POTTSVILLE |
| Zip Code Of The Provider | 17901 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 148 |
| Number Of Services | 8432 |
| Number Of Medicare Beneficiaries | 4189 |
| Total Submitted Charge Amount | 497955 |
| Total Medicare Allowed Amount | 161525.25 |
| Total Medicare Payment Amount | 132196.87 |
| Total Medicare Standardized Payment Amount | 136099.11 |
| 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 | 148 |
| Number Of Medical Services | 8432 |
| Number Of Medicare Beneficiaries With Medical Services | 4189 |
| Total Medical Submitted Charge Amount | 497955 |
| Total Medical Medicare Allowed Amount | 161525.25 |
| Total Medical Medicare Payment Amount | 132196.87 |
| Total Medical Medicare Standardized Payment Amount | 136099.11 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 745 |
| Number Of Beneficiaries Age 65 to 74 | 1542 |
| Number Of Beneficiaries Age 75 to 84 | 1153 |
| Number Of Beneficiaries Age Greater 84 | 749 |
| Number Of Female Beneficiaries | 2967 |
| Number Of Male Beneficiaries | 1222 |
| Number Of Non Hispanic White Beneficiaries | 4083 |
| Number Of Black or African American Beneficiaries | 24 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 41 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 26 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2943 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1246 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.4004 |