| National Provider Identifier [NPI]: | 1467457275 |
| Last Name Of The Provider | GOLDE |
| First Name Of The Provider | SCOTT |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | P.A.-C |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1010 WOODMAN DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | DAYTON |
| Zip Code Of The Provider | 454321400 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 28 |
| Number Of Services | 790 |
| Number Of Medicare Beneficiaries | 498 |
| Total Submitted Charge Amount | 111121 |
| Total Medicare Allowed Amount | 61733.31 |
| Total Medicare Payment Amount | 45205.04 |
| Total Medicare Standardized Payment Amount | 56131.6 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 13 |
| Number Of Medicare Beneficiaries With Drug Services | 11 |
| Total Drug Submitted ChargeAmount | 286 |
| Total Drug Medicare AllowedAmount | 77.91 |
| Total Drug Medicare PaymentAmount | 57.9 |
| Total Drug Medicare Standardized Payment Amount | 57.9 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 27 |
| Number Of Medical Services | 777 |
| Number Of Medicare Beneficiaries With Medical Services | 498 |
| Total Medical Submitted Charge Amount | 110835 |
| Total Medical Medicare Allowed Amount | 61655.4 |
| Total Medical Medicare Payment Amount | 45147.14 |
| Total Medical Medicare Standardized Payment Amount | 56073.7 |
| Average Age Of Beneficiaries | 65 |
| Number Of Beneficiaries Age Less65 | 231 |
| Number Of Beneficiaries Age 65 to 74 | 127 |
| Number Of Beneficiaries Age 75 to 84 | 85 |
| Number Of Beneficiaries Age Greater 84 | 55 |
| Number Of Female Beneficiaries | 270 |
| Number Of Male Beneficiaries | 228 |
| Number Of Non Hispanic White Beneficiaries | 360 |
| Number Of Black or African American Beneficiaries | 123 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 219 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 279 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 40 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 55 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 2.0216 |