| National Provider Identifier [NPI]: | 1871521237 |
| Last Name Of The Provider | GOODWIN |
| First Name Of The Provider | STEPHEN |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 37 SANDSTONE CIR |
| Street Address 2 Of The Provider | |
| City Of The Provider | JACKSON |
| Zip Code Of The Provider | 383052073 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 71 |
| Number Of Services | 4097 |
| Number Of Medicare Beneficiaries | 1590 |
| Total Submitted Charge Amount | 281046 |
| Total Medicare Allowed Amount | 115616.26 |
| Total Medicare Payment Amount | 80970.95 |
| Total Medicare Standardized Payment Amount | 86017.12 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 16 |
| Number Of Drug Services | 357 |
| Number Of Medicare Beneficiaries With Drug Services | 102 |
| Total Drug Submitted ChargeAmount | 5780 |
| Total Drug Medicare AllowedAmount | 1265.17 |
| Total Drug Medicare PaymentAmount | 985.71 |
| Total Drug Medicare Standardized Payment Amount | 985.71 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 55 |
| Number Of Medical Services | 3740 |
| Number Of Medicare Beneficiaries With Medical Services | 1590 |
| Total Medical Submitted Charge Amount | 275266 |
| Total Medical Medicare Allowed Amount | 114351.09 |
| Total Medical Medicare Payment Amount | 79985.24 |
| Total Medical Medicare Standardized Payment Amount | 85031.41 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 304 |
| Number Of Beneficiaries Age 65 to 74 | 639 |
| Number Of Beneficiaries Age 75 to 84 | 468 |
| Number Of Beneficiaries Age Greater 84 | 179 |
| Number Of Female Beneficiaries | 907 |
| Number Of Male Beneficiaries | 683 |
| Number Of Non Hispanic White Beneficiaries | 1312 |
| Number Of Black or African American Beneficiaries | 262 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1070 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 520 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 37 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 37 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 58 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.6676 |