| National Provider Identifier [NPI]: | 1760459499 |
| Last Name Of The Provider | GOFF |
| First Name Of The Provider | WALTER |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 10666 N TORREY PINES RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | LA JOLLA |
| Zip Code Of The Provider | 920371027 |
| 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 | 97 |
| Number Of Services | 15203 |
| Number Of Medicare Beneficiaries | 1848 |
| Total Submitted Charge Amount | 498960.4 |
| Total Medicare Allowed Amount | 169944.04 |
| Total Medicare Payment Amount | 121278.72 |
| Total Medicare Standardized Payment Amount | 119296.67 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 12769 |
| Number Of Medicare Beneficiaries With Drug Services | 125 |
| Total Drug Submitted ChargeAmount | 12789.4 |
| Total Drug Medicare AllowedAmount | 2448.57 |
| Total Drug Medicare PaymentAmount | 1919.57 |
| Total Drug Medicare Standardized Payment Amount | 1919.57 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 95 |
| Number Of Medical Services | 2434 |
| Number Of Medicare Beneficiaries With Medical Services | 1848 |
| Total Medical Submitted Charge Amount | 486171 |
| Total Medical Medicare Allowed Amount | 167495.47 |
| Total Medical Medicare Payment Amount | 119359.15 |
| Total Medical Medicare Standardized Payment Amount | 117377.1 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 144 |
| Number Of Beneficiaries Age 65 to 74 | 876 |
| Number Of Beneficiaries Age 75 to 84 | 551 |
| Number Of Beneficiaries Age Greater 84 | 277 |
| Number Of Female Beneficiaries | 1122 |
| Number Of Male Beneficiaries | 726 |
| Number Of Non Hispanic White Beneficiaries | 1467 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 150 |
| Number Of Hispanic Beneficiaries | 136 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 56 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1616 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 232 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 58 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.213 |