| National Provider Identifier [NPI]: | 1780605097 |
| Last Name Of The Provider | GOLDYN |
| First Name Of The Provider | LAWRENCE |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 205 SOUTH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | FORT BRAGG |
| Zip Code Of The Provider | 954375540 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 20 |
| Number Of Services | 264 |
| Number Of Medicare Beneficiaries | 178 |
| Total Submitted Charge Amount | 6844 |
| Total Medicare Allowed Amount | 4592.52 |
| Total Medicare Payment Amount | 3936.19 |
| Total Medicare Standardized Payment Amount | 3878.88 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 72 |
| Number Of Medicare Beneficiaries With Drug Services | 34 |
| Total Drug Submitted ChargeAmount | 3159 |
| Total Drug Medicare AllowedAmount | 2428.52 |
| Total Drug Medicare PaymentAmount | 2327.58 |
| Total Drug Medicare Standardized Payment Amount | 2327.58 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 17 |
| Number Of Medical Services | 192 |
| Number Of Medicare Beneficiaries With Medical Services | 146 |
| Total Medical Submitted Charge Amount | 3685 |
| Total Medical Medicare Allowed Amount | 2164 |
| Total Medical Medicare Payment Amount | 1608.61 |
| Total Medical Medicare Standardized Payment Amount | 1551.3 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 37 |
| Number Of Beneficiaries Age 65 to 74 | 89 |
| Number Of Beneficiaries Age 75 to 84 | 40 |
| Number Of Beneficiaries Age Greater 84 | 12 |
| Number Of Female Beneficiaries | 97 |
| Number Of Male Beneficiaries | 81 |
| Number Of Non Hispanic White Beneficiaries | 160 |
| 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 | |
| Number Of Beneficiaries With Medicare Only Entitlement | 113 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 65 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 43 |
| Percent Of With Hypertension | 61 |
| Percent Of With Ischemic Heart Disease | 15 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 24 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9073 |