| National Provider Identifier [NPI]: | 1700804366 |
| Last Name Of The Provider | GOLDBERG |
| First Name Of The Provider | MARK |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4790 E CAMP LOWELL DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | TUCSON |
| Zip Code Of The Provider | 857121275 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 35 |
| Number Of Services | 8727 |
| Number Of Medicare Beneficiaries | 1635 |
| Total Submitted Charge Amount | 1733583.45 |
| Total Medicare Allowed Amount | 941434.49 |
| Total Medicare Payment Amount | 700818.53 |
| Total Medicare Standardized Payment Amount | 708358.53 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 564 |
| Number Of Medicare Beneficiaries With Drug Services | 141 |
| Total Drug Submitted ChargeAmount | 39480 |
| Total Drug Medicare AllowedAmount | 29876.14 |
| Total Drug Medicare PaymentAmount | 23256.1 |
| Total Drug Medicare Standardized Payment Amount | 23256.1 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 34 |
| Number Of Medical Services | 8163 |
| Number Of Medicare Beneficiaries With Medical Services | 1635 |
| Total Medical Submitted Charge Amount | 1694103.45 |
| Total Medical Medicare Allowed Amount | 911558.35 |
| Total Medical Medicare Payment Amount | 677562.43 |
| Total Medical Medicare Standardized Payment Amount | 685102.43 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 35 |
| Number Of Beneficiaries Age 65 to 74 | 645 |
| Number Of Beneficiaries Age 75 to 84 | 676 |
| Number Of Beneficiaries Age Greater 84 | 279 |
| Number Of Female Beneficiaries | 810 |
| Number Of Male Beneficiaries | 825 |
| Number Of Non Hispanic White Beneficiaries | 1510 |
| Number Of Black or African American Beneficiaries | 23 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 70 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1596 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 39 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.0778 |