| National Provider Identifier [NPI]: | 1699764175 |
| Last Name Of The Provider | GOLDMAN |
| First Name Of The Provider | HOWARD |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 10159 VERREE RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | PHILADELPHIA |
| Zip Code Of The Provider | 191163613 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 65 |
| Number Of Services | 7099 |
| Number Of Medicare Beneficiaries | 1638 |
| Total Submitted Charge Amount | 661911 |
| Total Medicare Allowed Amount | 481731.8 |
| Total Medicare Payment Amount | 351403.95 |
| Total Medicare Standardized Payment Amount | 326561.25 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 27 |
| Number Of Medicare Beneficiaries With Drug Services | 21 |
| Total Drug Submitted ChargeAmount | 81 |
| Total Drug Medicare AllowedAmount | 47.93 |
| Total Drug Medicare PaymentAmount | 37.57 |
| Total Drug Medicare Standardized Payment Amount | 37.57 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 64 |
| Number Of Medical Services | 7072 |
| Number Of Medicare Beneficiaries With Medical Services | 1638 |
| Total Medical Submitted Charge Amount | 661830 |
| Total Medical Medicare Allowed Amount | 481683.87 |
| Total Medical Medicare Payment Amount | 351366.38 |
| Total Medical Medicare Standardized Payment Amount | 326523.68 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 100 |
| Number Of Beneficiaries Age 65 to 74 | 553 |
| Number Of Beneficiaries Age 75 to 84 | 710 |
| Number Of Beneficiaries Age Greater 84 | 275 |
| Number Of Female Beneficiaries | 942 |
| Number Of Male Beneficiaries | 696 |
| Number Of Non Hispanic White Beneficiaries | 1527 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 15 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 75 |
| Number Of Beneficiaries With Medicare Only Entitlement | 639 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 999 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 48 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 61 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 62 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.376 |