| National Provider Identifier [NPI]: | 1083651343 |
| Last Name Of The Provider | GOEWEY |
| First Name Of The Provider | STEPHEN |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 326 ASBURY AVE |
| Street Address 2 Of The Provider | STE 101 |
| City Of The Provider | RIPLEY |
| Zip Code Of The Provider | 38063 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 67 |
| Number Of Services | 1037 |
| Number Of Medicare Beneficiaries | 214 |
| Total Submitted Charge Amount | 55265.14 |
| Total Medicare Allowed Amount | 33223.55 |
| Total Medicare Payment Amount | 25461.83 |
| Total Medicare Standardized Payment Amount | 27308.14 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 234 |
| Number Of Medicare Beneficiaries With Drug Services | 77 |
| Total Drug Submitted ChargeAmount | 4246.1 |
| Total Drug Medicare AllowedAmount | 1065.96 |
| Total Drug Medicare PaymentAmount | 891.22 |
| Total Drug Medicare Standardized Payment Amount | 891.22 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 57 |
| Number Of Medical Services | 803 |
| Number Of Medicare Beneficiaries With Medical Services | 214 |
| Total Medical Submitted Charge Amount | 51019.04 |
| Total Medical Medicare Allowed Amount | 32157.59 |
| Total Medical Medicare Payment Amount | 24570.61 |
| Total Medical Medicare Standardized Payment Amount | 26416.92 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 27 |
| Number Of Beneficiaries Age 65 to 74 | 120 |
| Number Of Beneficiaries Age 75 to 84 | 52 |
| Number Of Beneficiaries Age Greater 84 | 15 |
| Number Of Female Beneficiaries | 126 |
| Number Of Male Beneficiaries | 88 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| 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 | 194 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 20 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 21 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9101 |