| National Provider Identifier [NPI]: | 1649251810 |
| Last Name Of The Provider | GOLDMAN |
| First Name Of The Provider | LARY |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 30335 W 13 MILE RD |
| Street Address 2 Of The Provider | SUITE 103 |
| City Of The Provider | FARMINGTON HILLS |
| Zip Code Of The Provider | 483342262 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 61 |
| Number Of Services | 5630 |
| Number Of Medicare Beneficiaries | 1015 |
| Total Submitted Charge Amount | 811825 |
| Total Medicare Allowed Amount | 522582.73 |
| Total Medicare Payment Amount | 393527.29 |
| Total Medicare Standardized Payment Amount | 387557.68 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 338 |
| Number Of Medicare Beneficiaries With Drug Services | 120 |
| Total Drug Submitted ChargeAmount | 22850 |
| Total Drug Medicare AllowedAmount | 16011.75 |
| Total Drug Medicare PaymentAmount | 12579.86 |
| Total Drug Medicare Standardized Payment Amount | 12579.86 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 59 |
| Number Of Medical Services | 5292 |
| Number Of Medicare Beneficiaries With Medical Services | 1015 |
| Total Medical Submitted Charge Amount | 788975 |
| Total Medical Medicare Allowed Amount | 506570.98 |
| Total Medical Medicare Payment Amount | 380947.43 |
| Total Medical Medicare Standardized Payment Amount | 374977.82 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 35 |
| Number Of Beneficiaries Age 65 to 74 | 324 |
| Number Of Beneficiaries Age 75 to 84 | 367 |
| Number Of Beneficiaries Age Greater 84 | 289 |
| Number Of Female Beneficiaries | 476 |
| Number Of Male Beneficiaries | 539 |
| Number Of Non Hispanic White Beneficiaries | 912 |
| Number Of Black or African American Beneficiaries | 72 |
| 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 | 16 |
| Number Of Beneficiaries With Medicare Only Entitlement | 949 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 66 |
| Percent Of With Atrial Fibrillation | 24 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.5111 |