| National Provider Identifier [NPI]: | 1417170432 |
| Last Name Of The Provider | GOLDENBERG |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1101 E MISSOURI AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | PHOENIX |
| Zip Code Of The Provider | 850142709 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 39 |
| Number Of Services | 18880 |
| Number Of Medicare Beneficiaries | 1749 |
| Total Submitted Charge Amount | 4918208.49 |
| Total Medicare Allowed Amount | 4883237.3 |
| Total Medicare Payment Amount | 3776644.53 |
| Total Medicare Standardized Payment Amount | 3784000.45 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 8179 |
| Number Of Medicare Beneficiaries With Drug Services | 557 |
| Total Drug Submitted ChargeAmount | 3714222.81 |
| Total Drug Medicare AllowedAmount | 3699414.03 |
| Total Drug Medicare PaymentAmount | 2892425.91 |
| Total Drug Medicare Standardized Payment Amount | 2892425.91 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 33 |
| Number Of Medical Services | 10701 |
| Number Of Medicare Beneficiaries With Medical Services | 1749 |
| Total Medical Submitted Charge Amount | 1203985.68 |
| Total Medical Medicare Allowed Amount | 1183823.27 |
| Total Medical Medicare Payment Amount | 884218.62 |
| Total Medical Medicare Standardized Payment Amount | 891574.54 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 50 |
| Number Of Beneficiaries Age 65 to 74 | 580 |
| Number Of Beneficiaries Age 75 to 84 | 692 |
| Number Of Beneficiaries Age Greater 84 | 427 |
| Number Of Female Beneficiaries | 977 |
| Number Of Male Beneficiaries | 772 |
| Number Of Non Hispanic White Beneficiaries | 1589 |
| Number Of Black or African American Beneficiaries | 22 |
| Number Of AsianPacific Islander Beneficiaries | 20 |
| Number Of Hispanic Beneficiaries | 84 |
| Number Of American Indian Alaska Native Beneficiaries | 18 |
| Number Of Beneficiaries With Race Not Else where Classified | 16 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1654 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 95 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.2941 |