| National Provider Identifier [NPI]: | 1578545034 |
| Last Name Of The Provider | GOLDSMITH |
| First Name Of The Provider | DANIEL |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 120 NORTHVIEW RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | SEDONA |
| Zip Code Of The Provider | 863365581 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 38 |
| Number Of Services | 4516 |
| Number Of Medicare Beneficiaries | 588 |
| Total Submitted Charge Amount | 263129.98 |
| Total Medicare Allowed Amount | 229647.4 |
| Total Medicare Payment Amount | 169736.43 |
| Total Medicare Standardized Payment Amount | 173873.22 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 618 |
| Number Of Medicare Beneficiaries With Drug Services | 252 |
| Total Drug Submitted ChargeAmount | 14922 |
| Total Drug Medicare AllowedAmount | 5934.44 |
| Total Drug Medicare PaymentAmount | 5479.95 |
| Total Drug Medicare Standardized Payment Amount | 5479.95 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 33 |
| Number Of Medical Services | 3898 |
| Number Of Medicare Beneficiaries With Medical Services | 588 |
| Total Medical Submitted Charge Amount | 248207.98 |
| Total Medical Medicare Allowed Amount | 223712.96 |
| Total Medical Medicare Payment Amount | 164256.48 |
| Total Medical Medicare Standardized Payment Amount | 168393.27 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 295 |
| Number Of Beneficiaries Age 75 to 84 | 213 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 307 |
| Number Of Male Beneficiaries | 281 |
| Number Of Non Hispanic White Beneficiaries | 559 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 11 |
| Number Of Beneficiaries With Medicare Only Entitlement | 576 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 12 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 5 |
| Percent Of With Chronic Kidney Disease | 10 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 6 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 14 |
| Percent Of With Hyperlipidemia | 29 |
| Percent Of With Hypertension | 34 |
| Percent Of With Ischemic Heart Disease | 18 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 29 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 2 |
| Average HCC Risk Score Of Beneficiaries | 0.7193 |