| National Provider Identifier [NPI]: | 1588629117 |
| Last Name Of The Provider | VAUGHAN |
| First Name Of The Provider | GEOFFREY |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3900 STONERIDGE LANE |
| Street Address 2 Of The Provider | |
| City Of The Provider | DUBLIN |
| Zip Code Of The Provider | 43017 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 46 |
| Number Of Services | 1539 |
| Number Of Medicare Beneficiaries | 423 |
| Total Submitted Charge Amount | 272782.7 |
| Total Medicare Allowed Amount | 127257.83 |
| Total Medicare Payment Amount | 93353.99 |
| Total Medicare Standardized Payment Amount | 97337.42 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 158 |
| Number Of Medicare Beneficiaries With Drug Services | 113 |
| Total Drug Submitted ChargeAmount | 29697.7 |
| Total Drug Medicare AllowedAmount | 10247.06 |
| Total Drug Medicare PaymentAmount | 10025.19 |
| Total Drug Medicare Standardized Payment Amount | 10025.19 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 37 |
| Number Of Medical Services | 1381 |
| Number Of Medicare Beneficiaries With Medical Services | 423 |
| Total Medical Submitted Charge Amount | 243085 |
| Total Medical Medicare Allowed Amount | 117010.77 |
| Total Medical Medicare Payment Amount | 83328.8 |
| Total Medical Medicare Standardized Payment Amount | 87312.23 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 113 |
| Number Of Beneficiaries Age 65 to 74 | 158 |
| Number Of Beneficiaries Age 75 to 84 | 106 |
| Number Of Beneficiaries Age Greater 84 | 46 |
| Number Of Female Beneficiaries | 211 |
| Number Of Male Beneficiaries | 212 |
| Number Of Non Hispanic White Beneficiaries | 327 |
| Number Of Black or African American Beneficiaries | 73 |
| Number Of AsianPacific Islander Beneficiaries | 11 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 285 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 138 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.5656 |