| National Provider Identifier [NPI]: | 1952377707 |
| Last Name Of The Provider | GOLDMAN |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 625 MONTAUK HWY |
| Street Address 2 Of The Provider | |
| City Of The Provider | CENTER MORICHES |
| Zip Code Of The Provider | 119342200 |
| State Code Of The Provider | NY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 99 |
| Number Of Services | 5728 |
| Number Of Medicare Beneficiaries | 619 |
| Total Submitted Charge Amount | 441292.38 |
| Total Medicare Allowed Amount | 331781.95 |
| Total Medicare Payment Amount | 256124.63 |
| Total Medicare Standardized Payment Amount | 226716.62 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 14 |
| Number Of Drug Services | 725 |
| Number Of Medicare Beneficiaries With Drug Services | 249 |
| Total Drug Submitted ChargeAmount | 12943 |
| Total Drug Medicare AllowedAmount | 7673.5 |
| Total Drug Medicare PaymentAmount | 7398.67 |
| Total Drug Medicare Standardized Payment Amount | 7398.67 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 85 |
| Number Of Medical Services | 5003 |
| Number Of Medicare Beneficiaries With Medical Services | 619 |
| Total Medical Submitted Charge Amount | 428349.38 |
| Total Medical Medicare Allowed Amount | 324108.45 |
| Total Medical Medicare Payment Amount | 248725.96 |
| Total Medical Medicare Standardized Payment Amount | 219317.95 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 120 |
| Number Of Beneficiaries Age 65 to 74 | 294 |
| Number Of Beneficiaries Age 75 to 84 | 140 |
| Number Of Beneficiaries Age Greater 84 | 65 |
| Number Of Female Beneficiaries | 360 |
| Number Of Male Beneficiaries | 259 |
| Number Of Non Hispanic White Beneficiaries | 560 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 21 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 18 |
| Number Of Beneficiaries With Medicare Only Entitlement | 559 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 60 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 10 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 30 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.9159 |