| National Provider Identifier [NPI]: | 1932106838 |
| Last Name Of The Provider | GOLDBERG |
| First Name Of The Provider | GERALD |
| Middle Initial Of The Provider | N |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5150 E GLENN ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | TUCSON |
| Zip Code Of The Provider | 857121337 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 63 |
| Number Of Services | 5198 |
| Number Of Medicare Beneficiaries | 1171 |
| Total Submitted Charge Amount | 691055 |
| Total Medicare Allowed Amount | 313001.42 |
| Total Medicare Payment Amount | 225888.51 |
| Total Medicare Standardized Payment Amount | 218922.6 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 95 |
| Number Of Medicare Beneficiaries With Drug Services | 40 |
| Total Drug Submitted ChargeAmount | 5572 |
| Total Drug Medicare AllowedAmount | 3367.62 |
| Total Drug Medicare PaymentAmount | 2529.93 |
| Total Drug Medicare Standardized Payment Amount | 2529.93 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 60 |
| Number Of Medical Services | 5103 |
| Number Of Medicare Beneficiaries With Medical Services | 1171 |
| Total Medical Submitted Charge Amount | 685483 |
| Total Medical Medicare Allowed Amount | 309633.8 |
| Total Medical Medicare Payment Amount | 223358.58 |
| Total Medical Medicare Standardized Payment Amount | 216392.67 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 23 |
| Number Of Beneficiaries Age 65 to 74 | 483 |
| Number Of Beneficiaries Age 75 to 84 | 461 |
| Number Of Beneficiaries Age Greater 84 | 204 |
| Number Of Female Beneficiaries | 551 |
| Number Of Male Beneficiaries | 620 |
| Number Of Non Hispanic White Beneficiaries | 1129 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 24 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1154 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 17 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 17 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 57 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.9631 |