| National Provider Identifier [NPI]: | 1548218175 |
| Last Name Of The Provider | GOULD |
| First Name Of The Provider | PAUL |
| Middle Initial Of The Provider | N |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2588 ELM ROAD NE |
| Street Address 2 Of The Provider | |
| City Of The Provider | CORTLAND |
| Zip Code Of The Provider | 444109298 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 197 |
| Number Of Services | 4157 |
| Number Of Medicare Beneficiaries | 2197 |
| Total Submitted Charge Amount | 674985 |
| Total Medicare Allowed Amount | 148295.69 |
| Total Medicare Payment Amount | 111466.35 |
| Total Medicare Standardized Payment Amount | 114405.92 |
| 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 | 197 |
| Number Of Medical Services | 4157 |
| Number Of Medicare Beneficiaries With Medical Services | 2197 |
| Total Medical Submitted Charge Amount | 674985 |
| Total Medical Medicare Allowed Amount | 148295.69 |
| Total Medical Medicare Payment Amount | 111466.35 |
| Total Medical Medicare Standardized Payment Amount | 114405.92 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 579 |
| Number Of Beneficiaries Age 65 to 74 | 800 |
| Number Of Beneficiaries Age 75 to 84 | 527 |
| Number Of Beneficiaries Age Greater 84 | 291 |
| Number Of Female Beneficiaries | 1339 |
| Number Of Male Beneficiaries | 858 |
| Number Of Non Hispanic White Beneficiaries | 1935 |
| Number Of Black or African American Beneficiaries | 204 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 26 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1499 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 698 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 35 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 33 |
| Percent Of With Depression | 38 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 55 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.9477 |