| National Provider Identifier [NPI]: | 1831166784 |
| Last Name Of The Provider | GOLDSTEIN |
| First Name Of The Provider | HARVEY |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 8401 DATAPOINT DR |
| Street Address 2 Of The Provider | SUITE 600 |
| City Of The Provider | SAN ANTONIO |
| Zip Code Of The Provider | 782295900 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 118 |
| Number Of Services | 3569 |
| Number Of Medicare Beneficiaries | 1786 |
| Total Submitted Charge Amount | 1084388 |
| Total Medicare Allowed Amount | 374909.66 |
| Total Medicare Payment Amount | 296167.97 |
| Total Medicare Standardized Payment Amount | 306352.92 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 676 |
| Number Of Medicare Beneficiaries With Drug Services | 31 |
| Total Drug Submitted ChargeAmount | 2483 |
| Total Drug Medicare AllowedAmount | 1235.61 |
| Total Drug Medicare PaymentAmount | 968.81 |
| Total Drug Medicare Standardized Payment Amount | 968.81 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 115 |
| Number Of Medical Services | 2893 |
| Number Of Medicare Beneficiaries With Medical Services | 1786 |
| Total Medical Submitted Charge Amount | 1081905 |
| Total Medical Medicare Allowed Amount | 373674.05 |
| Total Medical Medicare Payment Amount | 295199.16 |
| Total Medical Medicare Standardized Payment Amount | 305384.11 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 261 |
| Number Of Beneficiaries Age 65 to 74 | 745 |
| Number Of Beneficiaries Age 75 to 84 | 516 |
| Number Of Beneficiaries Age Greater 84 | 264 |
| Number Of Female Beneficiaries | 1202 |
| Number Of Male Beneficiaries | 584 |
| Number Of Non Hispanic White Beneficiaries | 1178 |
| Number Of Black or African American Beneficiaries | 69 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 497 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 22 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1453 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 333 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 25 |
| Percent Of With Heart Failure | 36 |
| Percent Of With Chronic Kidney Disease | 43 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 52 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.8526 |