| National Provider Identifier [NPI]: | 1235169707 |
| Last Name Of The Provider | GOETZ |
| First Name Of The Provider | CARL |
| 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 | 6401 COYLE AVENUE |
| Street Address 2 Of The Provider | #315 |
| City Of The Provider | CARMICHAEL |
| Zip Code Of The Provider | 95608 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 47 |
| Number Of Services | 27030 |
| Number Of Medicare Beneficiaries | 1989 |
| Total Submitted Charge Amount | 1155870 |
| Total Medicare Allowed Amount | 852115.9 |
| Total Medicare Payment Amount | 611527.49 |
| Total Medicare Standardized Payment Amount | 597220.14 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 47 |
| Number Of Medicare Beneficiaries With Drug Services | 29 |
| Total Drug Submitted ChargeAmount | 835 |
| Total Drug Medicare AllowedAmount | 83.77 |
| Total Drug Medicare PaymentAmount | 64.23 |
| Total Drug Medicare Standardized Payment Amount | 64.23 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 46 |
| Number Of Medical Services | 26983 |
| Number Of Medicare Beneficiaries With Medical Services | 1989 |
| Total Medical Submitted Charge Amount | 1155035 |
| Total Medical Medicare Allowed Amount | 852032.13 |
| Total Medical Medicare Payment Amount | 611463.26 |
| Total Medical Medicare Standardized Payment Amount | 597155.91 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 57 |
| Number Of Beneficiaries Age 65 to 74 | 818 |
| Number Of Beneficiaries Age 75 to 84 | 726 |
| Number Of Beneficiaries Age Greater 84 | 388 |
| Number Of Female Beneficiaries | 1023 |
| Number Of Male Beneficiaries | 966 |
| Number Of Non Hispanic White Beneficiaries | 1891 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 45 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 27 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1928 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 61 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 11 |
| Percent Of With Diabetes | 21 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 61 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.9823 |