| National Provider Identifier [NPI]: | 1033112156 |
| Last Name Of The Provider | GOLDEY |
| First Name Of The Provider | STACIA |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 17560 HIGHWAY 441 |
| Street Address 2 Of The Provider | |
| City Of The Provider | MOUNT DORA |
| Zip Code Of The Provider | 327576711 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 57 |
| Number Of Services | 12164 |
| Number Of Medicare Beneficiaries | 1517 |
| Total Submitted Charge Amount | 659863.73 |
| Total Medicare Allowed Amount | 547603.82 |
| Total Medicare Payment Amount | 414636.71 |
| Total Medicare Standardized Payment Amount | 371031.96 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 7474 |
| Number Of Medicare Beneficiaries With Drug Services | 50 |
| Total Drug Submitted ChargeAmount | 40569.67 |
| Total Drug Medicare AllowedAmount | 39865.96 |
| Total Drug Medicare PaymentAmount | 31252.5 |
| Total Drug Medicare Standardized Payment Amount | 31252.5 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 55 |
| Number Of Medical Services | 4690 |
| Number Of Medicare Beneficiaries With Medical Services | 1517 |
| Total Medical Submitted Charge Amount | 619294.06 |
| Total Medical Medicare Allowed Amount | 507737.86 |
| Total Medical Medicare Payment Amount | 383384.21 |
| Total Medical Medicare Standardized Payment Amount | 339779.46 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 44 |
| Number Of Beneficiaries Age 65 to 74 | 629 |
| Number Of Beneficiaries Age 75 to 84 | 606 |
| Number Of Beneficiaries Age Greater 84 | 238 |
| Number Of Female Beneficiaries | 957 |
| Number Of Male Beneficiaries | 560 |
| Number Of Non Hispanic White Beneficiaries | 1444 |
| Number Of Black or African American Beneficiaries | 26 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 27 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1455 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 62 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.1087 |