| National Provider Identifier [NPI]: | 1184603128 |
| Last Name Of The Provider | GOMBERG |
| First Name Of The Provider | CRAIG |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 555 E HARDY ST |
| Street Address 2 Of The Provider | CENTINELA HOSPITAL MEDICAL CENTER |
| City Of The Provider | INGLEWOOD |
| Zip Code Of The Provider | 90301 |
| 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 | 267 |
| Number Of Services | 9517 |
| Number Of Medicare Beneficiaries | 3894 |
| Total Submitted Charge Amount | 1519030.05 |
| Total Medicare Allowed Amount | 377916.05 |
| Total Medicare Payment Amount | 282383.05 |
| Total Medicare Standardized Payment Amount | 266329.23 |
| Drug Suppress Indicator | * |
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| Medical SuppressIndicator | # |
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| Number Of Medicare Beneficiaries With Medical Services | |
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| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 816 |
| Number Of Beneficiaries Age 65 to 74 | 1291 |
| Number Of Beneficiaries Age 75 to 84 | 1106 |
| Number Of Beneficiaries Age Greater 84 | 681 |
| Number Of Female Beneficiaries | 2404 |
| Number Of Male Beneficiaries | 1490 |
| Number Of Non Hispanic White Beneficiaries | 808 |
| Number Of Black or African American Beneficiaries | 2364 |
| Number Of AsianPacific Islander Beneficiaries | 105 |
| Number Of Hispanic Beneficiaries | 571 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1444 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 2450 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 26 |
| Percent Of With Asthma | 18 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 48 |
| Percent Of With Chronic Kidney Disease | 49 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 36 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 58 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 59 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 62 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 2.6405 |