| National Provider Identifier [NPI]: | 1871580845 |
| Last Name Of The Provider | GOLDSTEIN |
| First Name Of The Provider | LESLIE |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 258 HOOSICK ST |
| Street Address 2 Of The Provider | SUITE 101 |
| City Of The Provider | TROY |
| Zip Code Of The Provider | 121802427 |
| State Code Of The Provider | NY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nephrology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 24 |
| Number Of Services | 1318 |
| Number Of Medicare Beneficiaries | 454 |
| Total Submitted Charge Amount | 209818 |
| Total Medicare Allowed Amount | 151620.01 |
| Total Medicare Payment Amount | 113282.78 |
| Total Medicare Standardized Payment Amount | 120230.63 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 38 |
| Number Of Medicare Beneficiaries With Drug Services | 19 |
| Total Drug Submitted ChargeAmount | 930 |
| Total Drug Medicare AllowedAmount | 449.78 |
| Total Drug Medicare PaymentAmount | 395.12 |
| Total Drug Medicare Standardized Payment Amount | 395.12 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 22 |
| Number Of Medical Services | 1280 |
| Number Of Medicare Beneficiaries With Medical Services | 454 |
| Total Medical Submitted Charge Amount | 208888 |
| Total Medical Medicare Allowed Amount | 151170.23 |
| Total Medical Medicare Payment Amount | 112887.66 |
| Total Medical Medicare Standardized Payment Amount | 119835.51 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 101 |
| Number Of Beneficiaries Age 65 to 74 | 144 |
| Number Of Beneficiaries Age 75 to 84 | 123 |
| Number Of Beneficiaries Age Greater 84 | 86 |
| Number Of Female Beneficiaries | 228 |
| Number Of Male Beneficiaries | 226 |
| Number Of Non Hispanic White Beneficiaries | 388 |
| Number Of Black or African American Beneficiaries | 37 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 16 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 294 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 160 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 50 |
| Percent Of With Chronic Kidney Disease | 75 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 60 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 60 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 3.3949 |