| National Provider Identifier [NPI]: | 1033186960 |
| Last Name Of The Provider | GOODLIVE |
| First Name Of The Provider | THOMAS |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3705 OLENTANGY RIVER RD |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | COLUMBUS |
| Zip Code Of The Provider | 432143467 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 39 |
| Number Of Services | 5374 |
| Number Of Medicare Beneficiaries | 3202 |
| Total Submitted Charge Amount | 473140 |
| Total Medicare Allowed Amount | 225417.13 |
| Total Medicare Payment Amount | 169232.33 |
| Total Medicare Standardized Payment Amount | 174202.95 |
| 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 | 39 |
| Number Of Medical Services | 5374 |
| Number Of Medicare Beneficiaries With Medical Services | 3202 |
| Total Medical Submitted Charge Amount | 473140 |
| Total Medical Medicare Allowed Amount | 225417.13 |
| Total Medical Medicare Payment Amount | 169232.33 |
| Total Medical Medicare Standardized Payment Amount | 174202.95 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 499 |
| Number Of Beneficiaries Age 65 to 74 | 1124 |
| Number Of Beneficiaries Age 75 to 84 | 976 |
| Number Of Beneficiaries Age Greater 84 | 603 |
| Number Of Female Beneficiaries | 1666 |
| Number Of Male Beneficiaries | 1536 |
| Number Of Non Hispanic White Beneficiaries | 2919 |
| Number Of Black or African American Beneficiaries | 171 |
| Number Of AsianPacific Islander Beneficiaries | 39 |
| Number Of Hispanic Beneficiaries | 23 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 50 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2529 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 673 |
| Percent Of With Atrial Fibrillation | 29 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 43 |
| Percent Of With Chronic Kidney Disease | 44 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 64 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 1.7343 |