| National Provider Identifier [NPI]: | 1861572000 |
| Last Name Of The Provider | GODIALI |
| First Name Of The Provider | VASSO |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2010 15TH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | BAY CITY |
| Zip Code Of The Provider | 48708 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Vascular Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 248 |
| Number Of Services | 36450 |
| Number Of Medicare Beneficiaries | 1449 |
| Total Submitted Charge Amount | 39487565.5 |
| Total Medicare Allowed Amount | 14027165.73 |
| Total Medicare Payment Amount | 10978357.61 |
| Total Medicare Standardized Payment Amount | 11650760.1 |
| 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 | 248 |
| Number Of Medical Services | 36450 |
| Number Of Medicare Beneficiaries With Medical Services | 1449 |
| Total Medical Submitted Charge Amount | 39487565.5 |
| Total Medical Medicare Allowed Amount | 14027165.73 |
| Total Medical Medicare Payment Amount | 10978357.61 |
| Total Medical Medicare Standardized Payment Amount | 11650760.1 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 323 |
| Number Of Beneficiaries Age 65 to 74 | 478 |
| Number Of Beneficiaries Age 75 to 84 | 459 |
| Number Of Beneficiaries Age Greater 84 | 189 |
| Number Of Female Beneficiaries | 688 |
| Number Of Male Beneficiaries | 761 |
| Number Of Non Hispanic White Beneficiaries | 1285 |
| Number Of Black or African American Beneficiaries | 94 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 51 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 999 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 450 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 50 |
| Percent Of With Chronic Kidney Disease | 59 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 39 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 55 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 4.1228 |