| National Provider Identifier [NPI]: | 1710947247 |
| Last Name Of The Provider | GOLDSTEIN |
| First Name Of The Provider | MITCHELL |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 9880 BUSTLETON AVE |
| Street Address 2 Of The Provider | SUITE 332 |
| City Of The Provider | PHILADELPHIA |
| Zip Code Of The Provider | 191152185 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 18 |
| Number Of Services | 1126 |
| Number Of Medicare Beneficiaries | 318 |
| Total Submitted Charge Amount | 205144 |
| Total Medicare Allowed Amount | 102927.65 |
| Total Medicare Payment Amount | 77343.91 |
| Total Medicare Standardized Payment Amount | 69488.39 |
| 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 | 18 |
| Number Of Medical Services | 1126 |
| Number Of Medicare Beneficiaries With Medical Services | 318 |
| Total Medical Submitted Charge Amount | 205144 |
| Total Medical Medicare Allowed Amount | 102927.65 |
| Total Medical Medicare Payment Amount | 77343.91 |
| Total Medical Medicare Standardized Payment Amount | 69488.39 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 47 |
| Number Of Beneficiaries Age 65 to 74 | 119 |
| Number Of Beneficiaries Age 75 to 84 | 106 |
| Number Of Beneficiaries Age Greater 84 | 46 |
| Number Of Female Beneficiaries | 179 |
| Number Of Male Beneficiaries | 139 |
| Number Of Non Hispanic White Beneficiaries | 233 |
| Number Of Black or African American Beneficiaries | 59 |
| 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 | 11 |
| Number Of Beneficiaries With Medicare Only Entitlement | 193 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 125 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 31 |
| Percent Of With Heart Failure | 39 |
| Percent Of With Chronic Kidney Disease | 45 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 47 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 54 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 2.3447 |