| National Provider Identifier [NPI]: | 1316984958 |
| Last Name Of The Provider | GOLDMAN |
| First Name Of The Provider | RICHARD |
| 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 | 2202 WILSHIRE BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | SANTA MONICA |
| Zip Code Of The Provider | 904035706 |
| 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 | 161 |
| Number Of Services | 14952 |
| Number Of Medicare Beneficiaries | 2746 |
| Total Submitted Charge Amount | 1764850 |
| Total Medicare Allowed Amount | 376028.63 |
| Total Medicare Payment Amount | 285369.06 |
| Total Medicare Standardized Payment Amount | 264442.61 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 10348 |
| Number Of Medicare Beneficiaries With Drug Services | 223 |
| Total Drug Submitted ChargeAmount | 16838 |
| Total Drug Medicare AllowedAmount | 3700.7 |
| Total Drug Medicare PaymentAmount | 2789.44 |
| Total Drug Medicare Standardized Payment Amount | 2789.44 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 157 |
| Number Of Medical Services | 4604 |
| Number Of Medicare Beneficiaries With Medical Services | 2746 |
| Total Medical Submitted Charge Amount | 1748012 |
| Total Medical Medicare Allowed Amount | 372327.93 |
| Total Medical Medicare Payment Amount | 282579.62 |
| Total Medical Medicare Standardized Payment Amount | 261653.17 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 339 |
| Number Of Beneficiaries Age 65 to 74 | 910 |
| Number Of Beneficiaries Age 75 to 84 | 886 |
| Number Of Beneficiaries Age Greater 84 | 611 |
| Number Of Female Beneficiaries | 1615 |
| Number Of Male Beneficiaries | 1131 |
| Number Of Non Hispanic White Beneficiaries | 2132 |
| Number Of Black or African American Beneficiaries | 101 |
| Number Of AsianPacific Islander Beneficiaries | 141 |
| Number Of Hispanic Beneficiaries | 296 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2032 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 714 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 22 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 35 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 53 |
| Percent Of With Osteoporosis | 17 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 1.8246 |