| National Provider Identifier [NPI]: | 1518912138 |
| Last Name Of The Provider | GOLD |
| First Name Of The Provider | ADAM |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2322 S 57TH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | FORT SMITH |
| Zip Code Of The Provider | 729033813 |
| State Code Of The Provider | AR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 235 |
| Number Of Services | 9208 |
| Number Of Medicare Beneficiaries | 4479 |
| Total Submitted Charge Amount | 905117 |
| Total Medicare Allowed Amount | 227874.07 |
| Total Medicare Payment Amount | 177475.72 |
| Total Medicare Standardized Payment Amount | 193005.39 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 1590 |
| Number Of Medicare Beneficiaries With Drug Services | 29 |
| Total Drug Submitted ChargeAmount | 1695 |
| Total Drug Medicare AllowedAmount | 319.79 |
| Total Drug Medicare PaymentAmount | 246.75 |
| Total Drug Medicare Standardized Payment Amount | 246.75 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 233 |
| Number Of Medical Services | 7618 |
| Number Of Medicare Beneficiaries With Medical Services | 4479 |
| Total Medical Submitted Charge Amount | 903422 |
| Total Medical Medicare Allowed Amount | 227554.28 |
| Total Medical Medicare Payment Amount | 177228.97 |
| Total Medical Medicare Standardized Payment Amount | 192758.64 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 973 |
| Number Of Beneficiaries Age 65 to 74 | 1660 |
| Number Of Beneficiaries Age 75 to 84 | 1263 |
| Number Of Beneficiaries Age Greater 84 | 583 |
| Number Of Female Beneficiaries | 2751 |
| Number Of Male Beneficiaries | 1728 |
| Number Of Non Hispanic White Beneficiaries | 4115 |
| Number Of Black or African American Beneficiaries | 103 |
| Number Of AsianPacific Islander Beneficiaries | 36 |
| Number Of Hispanic Beneficiaries | 65 |
| Number Of American Indian Alaska Native Beneficiaries | 133 |
| Number Of Beneficiaries With Race Not Else where Classified | 27 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3200 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1279 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 33 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.4786 |