| National Provider Identifier [NPI]: | 1184610040 |
| Last Name Of The Provider | GOLDMAN |
| First Name Of The Provider | JASON |
| 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 | 3100 CORAL HILLS DR |
| Street Address 2 Of The Provider | SUITE #308 |
| City Of The Provider | CORAL SPRINGS |
| Zip Code Of The Provider | 330654137 |
| 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 | 55 |
| Number Of Services | 3292 |
| Number Of Medicare Beneficiaries | 129 |
| Total Submitted Charge Amount | 282097 |
| Total Medicare Allowed Amount | 150658.09 |
| Total Medicare Payment Amount | 120368.9 |
| Total Medicare Standardized Payment Amount | 113534.77 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 133 |
| Number Of Medicare Beneficiaries With Drug Services | 87 |
| Total Drug Submitted ChargeAmount | 13300 |
| Total Drug Medicare AllowedAmount | 5988.06 |
| Total Drug Medicare PaymentAmount | 5868.14 |
| Total Drug Medicare Standardized Payment Amount | 5868.14 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 51 |
| Number Of Medical Services | 3159 |
| Number Of Medicare Beneficiaries With Medical Services | 129 |
| Total Medical Submitted Charge Amount | 268797 |
| Total Medical Medicare Allowed Amount | 144670.03 |
| Total Medical Medicare Payment Amount | 114500.76 |
| Total Medical Medicare Standardized Payment Amount | 107666.63 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 12 |
| Number Of Beneficiaries Age 65 to 74 | 78 |
| Number Of Beneficiaries Age 75 to 84 | 25 |
| Number Of Beneficiaries Age Greater 84 | 14 |
| Number Of Female Beneficiaries | 63 |
| Number Of Male Beneficiaries | 66 |
| Number Of Non Hispanic White Beneficiaries | 108 |
| 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 | 118 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 11 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.0682 |