| National Provider Identifier [NPI]: | 1740227594 |
| Last Name Of The Provider | ROTH |
| First Name Of The Provider | GERALD |
| Middle Initial Of The Provider | M |
| 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 | 106 |
| Number Of Services | 16605 |
| Number Of Medicare Beneficiaries | 2460 |
| Total Submitted Charge Amount | 1079417 |
| Total Medicare Allowed Amount | 273907.7 |
| Total Medicare Payment Amount | 204502.28 |
| Total Medicare Standardized Payment Amount | 186707.8 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 11899 |
| Number Of Medicare Beneficiaries With Drug Services | 149 |
| Total Drug Submitted ChargeAmount | 13355 |
| Total Drug Medicare AllowedAmount | 2658.49 |
| Total Drug Medicare PaymentAmount | 2065.46 |
| Total Drug Medicare Standardized Payment Amount | 2065.46 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 104 |
| Number Of Medical Services | 4706 |
| Number Of Medicare Beneficiaries With Medical Services | 2460 |
| Total Medical Submitted Charge Amount | 1066062 |
| Total Medical Medicare Allowed Amount | 271249.21 |
| Total Medical Medicare Payment Amount | 202436.82 |
| Total Medical Medicare Standardized Payment Amount | 184642.34 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 320 |
| Number Of Beneficiaries Age 65 to 74 | 883 |
| Number Of Beneficiaries Age 75 to 84 | 755 |
| Number Of Beneficiaries Age Greater 84 | 502 |
| Number Of Female Beneficiaries | 1439 |
| Number Of Male Beneficiaries | 1021 |
| Number Of Non Hispanic White Beneficiaries | 1890 |
| Number Of Black or African American Beneficiaries | 77 |
| Number Of AsianPacific Islander Beneficiaries | 122 |
| Number Of Hispanic Beneficiaries | 325 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1771 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 689 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 34 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 17 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.8113 |