| National Provider Identifier [NPI]: | 1952396186 |
| Last Name Of The Provider | GOLDBERG |
| First Name Of The Provider | MARC |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2000 S WHEELING AVE |
| Street Address 2 Of The Provider | SUITE 501 |
| City Of The Provider | TULSA |
| Zip Code Of The Provider | 741045639 |
| State Code Of The Provider | OK |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 35 |
| Number Of Services | 3503 |
| Number Of Medicare Beneficiaries | 1275 |
| Total Submitted Charge Amount | 1518959 |
| Total Medicare Allowed Amount | 511910.2 |
| Total Medicare Payment Amount | 369932.93 |
| Total Medicare Standardized Payment Amount | 409649.24 |
| 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 | 35 |
| Number Of Medical Services | 3503 |
| Number Of Medicare Beneficiaries With Medical Services | 1275 |
| Total Medical Submitted Charge Amount | 1518959 |
| Total Medical Medicare Allowed Amount | 511910.2 |
| Total Medical Medicare Payment Amount | 369932.93 |
| Total Medical Medicare Standardized Payment Amount | 409649.24 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 63 |
| Number Of Beneficiaries Age 65 to 74 | 590 |
| Number Of Beneficiaries Age 75 to 84 | 451 |
| Number Of Beneficiaries Age Greater 84 | 171 |
| Number Of Female Beneficiaries | 831 |
| Number Of Male Beneficiaries | 444 |
| Number Of Non Hispanic White Beneficiaries | 1126 |
| Number Of Black or African American Beneficiaries | 48 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 63 |
| Number Of Beneficiaries With Race Not Else where Classified | 18 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1178 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 97 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 44 |
| Percent Of With Hypertension | 61 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.9879 |