| National Provider Identifier [NPI]: | 1952386419 |
| Last Name Of The Provider | GOLDSTEIN |
| First Name Of The Provider | WARREN |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1400 E BOULDER ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | COLORADO SPRINGS |
| Zip Code Of The Provider | 809095533 |
| State Code Of The Provider | CO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 260 |
| Number Of Services | 6421 |
| Number Of Medicare Beneficiaries | 4212 |
| Total Submitted Charge Amount | 690257.42 |
| Total Medicare Allowed Amount | 229499.16 |
| Total Medicare Payment Amount | 169427.57 |
| Total Medicare Standardized Payment Amount | 171562.3 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 260 |
| Number Of Medical Services | 6421 |
| Number Of Medicare Beneficiaries With Medical Services | 4212 |
| Total Medical Submitted Charge Amount | 690257.42 |
| Total Medical Medicare Allowed Amount | 229499.16 |
| Total Medical Medicare Payment Amount | 169427.57 |
| Total Medical Medicare Standardized Payment Amount | 171562.3 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 859 |
| Number Of Beneficiaries Age 65 to 74 | 1417 |
| Number Of Beneficiaries Age 75 to 84 | 1322 |
| Number Of Beneficiaries Age Greater 84 | 614 |
| Number Of Female Beneficiaries | 2454 |
| Number Of Male Beneficiaries | 1758 |
| Number Of Non Hispanic White Beneficiaries | 3306 |
| Number Of Black or African American Beneficiaries | 294 |
| Number Of AsianPacific Islander Beneficiaries | 66 |
| Number Of Hispanic Beneficiaries | 477 |
| Number Of American Indian Alaska Native Beneficiaries | 16 |
| Number Of Beneficiaries With Race Not Else where Classified | 53 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3233 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 979 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.5388 |