| National Provider Identifier [NPI]: | 1669408910 |
| Last Name Of The Provider | GOEL |
| First Name Of The Provider | AMITABH |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1947 FOUNDERS ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | WICHITA |
| Zip Code Of The Provider | 672063548 |
| State Code Of The Provider | KS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Interventional Pain Management |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 72 |
| Number Of Services | 10253 |
| Number Of Medicare Beneficiaries | 630 |
| Total Submitted Charge Amount | 1339405.5 |
| Total Medicare Allowed Amount | 431880.04 |
| Total Medicare Payment Amount | 329031.85 |
| Total Medicare Standardized Payment Amount | 347349.39 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 14 |
| Number Of Drug Services | 6792 |
| Number Of Medicare Beneficiaries With Drug Services | 504 |
| Total Drug Submitted ChargeAmount | 35070 |
| Total Drug Medicare AllowedAmount | 14069.32 |
| Total Drug Medicare PaymentAmount | 10522.78 |
| Total Drug Medicare Standardized Payment Amount | 10522.78 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 58 |
| Number Of Medical Services | 3461 |
| Number Of Medicare Beneficiaries With Medical Services | 628 |
| Total Medical Submitted Charge Amount | 1304335.5 |
| Total Medical Medicare Allowed Amount | 417810.72 |
| Total Medical Medicare Payment Amount | 318509.07 |
| Total Medical Medicare Standardized Payment Amount | 336826.61 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 108 |
| Number Of Beneficiaries Age 65 to 74 | 220 |
| Number Of Beneficiaries Age 75 to 84 | 201 |
| Number Of Beneficiaries Age Greater 84 | 101 |
| Number Of Female Beneficiaries | 423 |
| Number Of Male Beneficiaries | 207 |
| Number Of Non Hispanic White Beneficiaries | 556 |
| Number Of Black or African American Beneficiaries | 37 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 19 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 548 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 82 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.0441 |