| National Provider Identifier [NPI]: | 1508804386 |
| Last Name Of The Provider | GOLD |
| First Name Of The Provider | JEFFREY |
| 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 | 3535 W 13 MILE RD |
| Street Address 2 Of The Provider | SUITE 247 |
| City Of The Provider | ROYAL OAK |
| Zip Code Of The Provider | 480736770 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nephrology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 30 |
| Number Of Services | 5612 |
| Number Of Medicare Beneficiaries | 802 |
| Total Submitted Charge Amount | 1172765 |
| Total Medicare Allowed Amount | 452039.53 |
| Total Medicare Payment Amount | 348814.54 |
| Total Medicare Standardized Payment Amount | 339602.84 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 1406 |
| Number Of Medicare Beneficiaries With Drug Services | 34 |
| Total Drug Submitted ChargeAmount | 56240 |
| Total Drug Medicare AllowedAmount | 16147.97 |
| Total Drug Medicare PaymentAmount | 12458.43 |
| Total Drug Medicare Standardized Payment Amount | 12458.43 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 28 |
| Number Of Medical Services | 4206 |
| Number Of Medicare Beneficiaries With Medical Services | 802 |
| Total Medical Submitted Charge Amount | 1116525 |
| Total Medical Medicare Allowed Amount | 435891.56 |
| Total Medical Medicare Payment Amount | 336356.11 |
| Total Medical Medicare Standardized Payment Amount | 327144.41 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 154 |
| Number Of Beneficiaries Age 65 to 74 | 251 |
| Number Of Beneficiaries Age 75 to 84 | 270 |
| Number Of Beneficiaries Age Greater 84 | 127 |
| Number Of Female Beneficiaries | 372 |
| Number Of Male Beneficiaries | 430 |
| Number Of Non Hispanic White Beneficiaries | 585 |
| Number Of Black or African American Beneficiaries | 168 |
| Number Of AsianPacific Islander Beneficiaries | 14 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 21 |
| Number Of Beneficiaries With Medicare Only Entitlement | 651 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 151 |
| Percent Of With Atrial Fibrillation | 31 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 60 |
| Percent Of With Chronic Kidney Disease | 75 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 33 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 61 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 72 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 3.9414 |