| National Provider Identifier [NPI]: | 1437192853 |
| Last Name Of The Provider | GODBEY |
| First Name Of The Provider | TERESA |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 800 5TH AVE |
| Street Address 2 Of The Provider | SUITE 300 |
| City Of The Provider | FORT WORTH |
| Zip Code Of The Provider | 761047300 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 107 |
| Number Of Services | 7651 |
| Number Of Medicare Beneficiaries | 465 |
| Total Submitted Charge Amount | 448501 |
| Total Medicare Allowed Amount | 236578.62 |
| Total Medicare Payment Amount | 187663.99 |
| Total Medicare Standardized Payment Amount | 190905.3 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 173 |
| Number Of Medicare Beneficiaries With Drug Services | 144 |
| Total Drug Submitted ChargeAmount | 8043 |
| Total Drug Medicare AllowedAmount | 4545.1 |
| Total Drug Medicare PaymentAmount | 4444.41 |
| Total Drug Medicare Standardized Payment Amount | 4444.41 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 98 |
| Number Of Medical Services | 7478 |
| Number Of Medicare Beneficiaries With Medical Services | 465 |
| Total Medical Submitted Charge Amount | 440458 |
| Total Medical Medicare Allowed Amount | 232033.52 |
| Total Medical Medicare Payment Amount | 183219.58 |
| Total Medical Medicare Standardized Payment Amount | 186460.89 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 183 |
| Number Of Beneficiaries Age 75 to 84 | 180 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 358 |
| Number Of Male Beneficiaries | 107 |
| Number Of Non Hispanic White Beneficiaries | 445 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 21 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 23 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.9894 |