| National Provider Identifier [NPI]: | 1750542445 |
| Last Name Of The Provider | GOLDMAN |
| First Name Of The Provider | BABAK |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 9524 FORT HAMILTON PKWY |
| Street Address 2 Of The Provider | |
| City Of The Provider | BROOKLYN |
| Zip Code Of The Provider | 112097452 |
| State Code Of The Provider | NY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hospice and Palliative Care |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 7 |
| Number Of Services | 694 |
| Number Of Medicare Beneficiaries | 321 |
| Total Submitted Charge Amount | 149240 |
| Total Medicare Allowed Amount | 111691.33 |
| Total Medicare Payment Amount | 86397.13 |
| Total Medicare Standardized Payment Amount | 82906.68 |
| 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 | 7 |
| Number Of Medical Services | 694 |
| Number Of Medicare Beneficiaries With Medical Services | 321 |
| Total Medical Submitted Charge Amount | 149240 |
| Total Medical Medicare Allowed Amount | 111691.33 |
| Total Medical Medicare Payment Amount | 86397.13 |
| Total Medical Medicare Standardized Payment Amount | 82906.68 |
| Average Age Of Beneficiaries | 80 |
| Number Of Beneficiaries Age Less65 | 24 |
| Number Of Beneficiaries Age 65 to 74 | 67 |
| Number Of Beneficiaries Age 75 to 84 | 105 |
| Number Of Beneficiaries Age Greater 84 | 125 |
| Number Of Female Beneficiaries | 180 |
| Number Of Male Beneficiaries | 141 |
| Number Of Non Hispanic White Beneficiaries | 225 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 23 |
| Number Of Hispanic Beneficiaries | 53 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 159 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 162 |
| Percent Of With Atrial Fibrillation | 35 |
| Percent Of With Alzheimers Disease or Dementia | 51 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 23 |
| Percent Of With Heart Failure | 65 |
| Percent Of With Chronic Kidney Disease | 69 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 38 |
| Percent Of With Depression | 37 |
| Percent Of With Diabetes | 51 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 64 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 17 |
| Percent Of With Stroke | 21 |
| Average HCC Risk Score Of Beneficiaries | 3.4539 |