| National Provider Identifier [NPI]: | 1982666855 |
| Last Name Of The Provider | GOODMAN |
| First Name Of The Provider | ROBERT |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1331 MEDICAL CENTER DR |
| Street Address 2 Of The Provider | SUITE C |
| City Of The Provider | ROHNERT PARK |
| Zip Code Of The Provider | 949282900 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | General Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 13 |
| Number Of Services | 2202 |
| Number Of Medicare Beneficiaries | 223 |
| Total Submitted Charge Amount | 198425 |
| Total Medicare Allowed Amount | 168882.56 |
| Total Medicare Payment Amount | 124656.48 |
| Total Medicare Standardized Payment Amount | 119912.1 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 34 |
| Number Of Medicare Beneficiaries With Drug Services | 17 |
| Total Drug Submitted ChargeAmount | 850 |
| Total Drug Medicare AllowedAmount | 190.98 |
| Total Drug Medicare PaymentAmount | 149.73 |
| Total Drug Medicare Standardized Payment Amount | 149.73 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 12 |
| Number Of Medical Services | 2168 |
| Number Of Medicare Beneficiaries With Medical Services | 223 |
| Total Medical Submitted Charge Amount | 197575 |
| Total Medical Medicare Allowed Amount | 168691.58 |
| Total Medical Medicare Payment Amount | 124506.75 |
| Total Medical Medicare Standardized Payment Amount | 119762.37 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 17 |
| Number Of Beneficiaries Age 65 to 74 | 127 |
| Number Of Beneficiaries Age 75 to 84 | 48 |
| Number Of Beneficiaries Age Greater 84 | 31 |
| Number Of Female Beneficiaries | 114 |
| Number Of Male Beneficiaries | 109 |
| Number Of Non Hispanic White Beneficiaries | 192 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 12 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 211 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 12 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 57 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 58 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 6 |
| Percent Of With Diabetes | 48 |
| Percent Of With Hyperlipidemia | 39 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 26 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.2114 |