| National Provider Identifier [NPI]: | 1245337302 |
| Last Name Of The Provider | GOODING |
| First Name Of The Provider | JUSTIN |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 410 S MELROSE DR |
| Street Address 2 Of The Provider | SUITE 104 |
| City Of The Provider | VISTA |
| Zip Code Of The Provider | 920816642 |
| 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 | 196 |
| Number Of Services | 2900 |
| Number Of Medicare Beneficiaries | 506 |
| Total Submitted Charge Amount | 1217280.23 |
| Total Medicare Allowed Amount | 338033.59 |
| Total Medicare Payment Amount | 262440.77 |
| Total Medicare Standardized Payment Amount | 256957.62 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 1139 |
| Number Of Medicare Beneficiaries With Drug Services | 45 |
| Total Drug Submitted ChargeAmount | 5964 |
| Total Drug Medicare AllowedAmount | 1733.62 |
| Total Drug Medicare PaymentAmount | 1359.17 |
| Total Drug Medicare Standardized Payment Amount | 1359.17 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 191 |
| Number Of Medical Services | 1761 |
| Number Of Medicare Beneficiaries With Medical Services | 506 |
| Total Medical Submitted Charge Amount | 1211316.23 |
| Total Medical Medicare Allowed Amount | 336299.97 |
| Total Medical Medicare Payment Amount | 261081.6 |
| Total Medical Medicare Standardized Payment Amount | 255598.45 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 108 |
| Number Of Beneficiaries Age 65 to 74 | 154 |
| Number Of Beneficiaries Age 75 to 84 | 144 |
| Number Of Beneficiaries Age Greater 84 | 100 |
| Number Of Female Beneficiaries | 259 |
| Number Of Male Beneficiaries | 247 |
| Number Of Non Hispanic White Beneficiaries | 333 |
| Number Of Black or African American Beneficiaries | 23 |
| Number Of AsianPacific Islander Beneficiaries | 31 |
| Number Of Hispanic Beneficiaries | 101 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 339 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 167 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 41 |
| Percent Of With Chronic Kidney Disease | 57 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 46 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 3.1504 |