| National Provider Identifier [NPI]: | 1649322439 |
| Last Name Of The Provider | GOODMAN |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 800 BIESTERFIELD RD |
| Street Address 2 Of The Provider | SUITE 505 |
| City Of The Provider | ELK GROVE VILLAGE |
| Zip Code Of The Provider | 600073311 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 40 |
| Number Of Services | 5506 |
| Number Of Medicare Beneficiaries | 935 |
| Total Submitted Charge Amount | 442445 |
| Total Medicare Allowed Amount | 313848.75 |
| Total Medicare Payment Amount | 228126.28 |
| Total Medicare Standardized Payment Amount | 210442.11 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 171 |
| Number Of Medicare Beneficiaries With Drug Services | 171 |
| Total Drug Submitted ChargeAmount | 4275 |
| Total Drug Medicare AllowedAmount | 2633.4 |
| Total Drug Medicare PaymentAmount | 2580.39 |
| Total Drug Medicare Standardized Payment Amount | 2580.39 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 39 |
| Number Of Medical Services | 5335 |
| Number Of Medicare Beneficiaries With Medical Services | 935 |
| Total Medical Submitted Charge Amount | 438170 |
| Total Medical Medicare Allowed Amount | 311215.35 |
| Total Medical Medicare Payment Amount | 225545.89 |
| Total Medical Medicare Standardized Payment Amount | 207861.72 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 39 |
| Number Of Beneficiaries Age 65 to 74 | 342 |
| Number Of Beneficiaries Age 75 to 84 | 374 |
| Number Of Beneficiaries Age Greater 84 | 180 |
| Number Of Female Beneficiaries | 525 |
| Number Of Male Beneficiaries | 410 |
| Number Of Non Hispanic White Beneficiaries | 877 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 26 |
| Number Of Hispanic Beneficiaries | 15 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 884 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 51 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 11 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.2513 |