| National Provider Identifier [NPI]: | 1851381826 |
| Last Name Of The Provider | GOTWAY |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3501 N SCOTTSDALE RD |
| Street Address 2 Of The Provider | STE 130 |
| City Of The Provider | SCOTTSDALE |
| Zip Code Of The Provider | 852515648 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 40 |
| Number Of Services | 19648 |
| Number Of Medicare Beneficiaries | 3678 |
| Total Submitted Charge Amount | 412721.95 |
| Total Medicare Allowed Amount | 252635.42 |
| Total Medicare Payment Amount | 184838.28 |
| Total Medicare Standardized Payment Amount | 217609.15 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 10700 |
| Number Of Medicare Beneficiaries With Drug Services | 100 |
| Total Drug Submitted ChargeAmount | 2035.8 |
| Total Drug Medicare AllowedAmount | 1910.92 |
| Total Drug Medicare PaymentAmount | 1222.7 |
| Total Drug Medicare Standardized Payment Amount | 1222.7 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 38 |
| Number Of Medical Services | 8948 |
| Number Of Medicare Beneficiaries With Medical Services | 3678 |
| Total Medical Submitted Charge Amount | 410686.15 |
| Total Medical Medicare Allowed Amount | 250724.5 |
| Total Medical Medicare Payment Amount | 183615.58 |
| Total Medical Medicare Standardized Payment Amount | 216386.45 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 291 |
| Number Of Beneficiaries Age 65 to 74 | 1437 |
| Number Of Beneficiaries Age 75 to 84 | 1373 |
| Number Of Beneficiaries Age Greater 84 | 577 |
| Number Of Female Beneficiaries | 1670 |
| Number Of Male Beneficiaries | 2008 |
| Number Of Non Hispanic White Beneficiaries | 3344 |
| Number Of Black or African American Beneficiaries | 61 |
| Number Of AsianPacific Islander Beneficiaries | 47 |
| Number Of Hispanic Beneficiaries | 138 |
| Number Of American Indian Alaska Native Beneficiaries | 38 |
| Number Of Beneficiaries With Race Not Else where Classified | 50 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3523 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 155 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 26 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.798 |