| National Provider Identifier [NPI]: | 1407824626 |
| Last Name Of The Provider | GOODMAN |
| First Name Of The Provider | SUSAN |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1915 W BEEBE CAPPS EXPY |
| Street Address 2 Of The Provider | |
| City Of The Provider | SEARCY |
| Zip Code Of The Provider | 721435012 |
| State Code Of The Provider | AR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pathology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 12 |
| Number Of Services | 6610 |
| Number Of Medicare Beneficiaries | 2603 |
| Total Submitted Charge Amount | 1312834 |
| Total Medicare Allowed Amount | 367061.54 |
| Total Medicare Payment Amount | 276314.82 |
| Total Medicare Standardized Payment Amount | 188912.34 |
| 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 | 12 |
| Number Of Medical Services | 6610 |
| Number Of Medicare Beneficiaries With Medical Services | 2603 |
| Total Medical Submitted Charge Amount | 1312834 |
| Total Medical Medicare Allowed Amount | 367061.54 |
| Total Medical Medicare Payment Amount | 276314.82 |
| Total Medical Medicare Standardized Payment Amount | 188912.34 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 407 |
| Number Of Beneficiaries Age 65 to 74 | 1471 |
| Number Of Beneficiaries Age 75 to 84 | 640 |
| Number Of Beneficiaries Age Greater 84 | 85 |
| Number Of Female Beneficiaries | 1461 |
| Number Of Male Beneficiaries | 1142 |
| Number Of Non Hispanic White Beneficiaries | 2206 |
| Number Of Black or African American Beneficiaries | 241 |
| Number Of AsianPacific Islander Beneficiaries | 39 |
| Number Of Hispanic Beneficiaries | 74 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2186 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 417 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 4 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.971 |