| National Provider Identifier [NPI]: | 1700814928 |
| Last Name Of The Provider | GOLDSTEIN |
| First Name Of The Provider | LAURENCE |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7253 AMBASSADOR RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | BALTIMORE |
| Zip Code Of The Provider | 212442710 |
| 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 | 193 |
| Number Of Services | 28573 |
| Number Of Medicare Beneficiaries | 4425 |
| Total Submitted Charge Amount | 2623718.54 |
| Total Medicare Allowed Amount | 1076638.8 |
| Total Medicare Payment Amount | 832474.29 |
| Total Medicare Standardized Payment Amount | 811595.95 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 22514 |
| Number Of Medicare Beneficiaries With Drug Services | 255 |
| Total Drug Submitted ChargeAmount | 5610.41 |
| Total Drug Medicare AllowedAmount | 4451.57 |
| Total Drug Medicare PaymentAmount | 3342.17 |
| Total Drug Medicare Standardized Payment Amount | 3342.17 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 187 |
| Number Of Medical Services | 6059 |
| Number Of Medicare Beneficiaries With Medical Services | 4425 |
| Total Medical Submitted Charge Amount | 2618108.13 |
| Total Medical Medicare Allowed Amount | 1072187.23 |
| Total Medical Medicare Payment Amount | 829132.12 |
| Total Medical Medicare Standardized Payment Amount | 808253.78 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 504 |
| Number Of Beneficiaries Age 65 to 74 | 1842 |
| Number Of Beneficiaries Age 75 to 84 | 1407 |
| Number Of Beneficiaries Age Greater 84 | 672 |
| Number Of Female Beneficiaries | 2717 |
| Number Of Male Beneficiaries | 1708 |
| Number Of Non Hispanic White Beneficiaries | 3597 |
| Number Of Black or African American Beneficiaries | 653 |
| Number Of AsianPacific Islander Beneficiaries | 79 |
| Number Of Hispanic Beneficiaries | 46 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 50 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3805 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 620 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 23 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.5302 |