| National Provider Identifier [NPI]: | 1851393847 |
| Last Name Of The Provider | NOMBERG |
| First Name Of The Provider | ADAM |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 100 MANETTO HILL RD |
| Street Address 2 Of The Provider | SUITE 105 |
| City Of The Provider | PLAINVIEW |
| Zip Code Of The Provider | 118031311 |
| State Code Of The Provider | NY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 13 |
| Number Of Services | 1304 |
| Number Of Medicare Beneficiaries | 400 |
| Total Submitted Charge Amount | 156445 |
| Total Medicare Allowed Amount | 135734.95 |
| Total Medicare Payment Amount | 94754.99 |
| Total Medicare Standardized Payment Amount | 82868.46 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 13 |
| Number Of Medical Services | 1304 |
| Number Of Medicare Beneficiaries With Medical Services | 400 |
| Total Medical Submitted Charge Amount | 156445 |
| Total Medical Medicare Allowed Amount | 135734.95 |
| Total Medical Medicare Payment Amount | 94754.99 |
| Total Medical Medicare Standardized Payment Amount | 82868.46 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 27 |
| Number Of Beneficiaries Age 65 to 74 | 217 |
| Number Of Beneficiaries Age 75 to 84 | 111 |
| Number Of Beneficiaries Age Greater 84 | 45 |
| Number Of Female Beneficiaries | 223 |
| Number Of Male Beneficiaries | 177 |
| Number Of Non Hispanic White Beneficiaries | 351 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 15 |
| Number Of Hispanic Beneficiaries | 14 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 370 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 30 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 3 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.99 |