| National Provider Identifier [NPI]: | 1215995345 |
| Last Name Of The Provider | GOLDSTEIN |
| First Name Of The Provider | GARY |
| 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 | 3890 TAMPA RD |
| Street Address 2 Of The Provider | SUITE 102 |
| City Of The Provider | PALM HARBOR |
| Zip Code Of The Provider | 346843676 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 60 |
| Number Of Services | 2887 |
| Number Of Medicare Beneficiaries | 328 |
| Total Submitted Charge Amount | 455662.29 |
| Total Medicare Allowed Amount | 148738.73 |
| Total Medicare Payment Amount | 106144.68 |
| Total Medicare Standardized Payment Amount | 106978.52 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 466 |
| Number Of Medicare Beneficiaries With Drug Services | 62 |
| Total Drug Submitted ChargeAmount | 4499.29 |
| Total Drug Medicare AllowedAmount | 530.2 |
| Total Drug Medicare PaymentAmount | 437.69 |
| Total Drug Medicare Standardized Payment Amount | 437.69 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 49 |
| Number Of Medical Services | 2421 |
| Number Of Medicare Beneficiaries With Medical Services | 328 |
| Total Medical Submitted Charge Amount | 451163 |
| Total Medical Medicare Allowed Amount | 148208.53 |
| Total Medical Medicare Payment Amount | 105706.99 |
| Total Medical Medicare Standardized Payment Amount | 106540.83 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 28 |
| Number Of Beneficiaries Age 65 to 74 | 148 |
| Number Of Beneficiaries Age 75 to 84 | 100 |
| Number Of Beneficiaries Age Greater 84 | 52 |
| Number Of Female Beneficiaries | 176 |
| Number Of Male Beneficiaries | 152 |
| Number Of Non Hispanic White Beneficiaries | 312 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 306 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 22 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 53 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 59 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.1887 |