| National Provider Identifier [NPI]: | 1023009362 |
| Last Name Of The Provider | GODFREY |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 914 N DIXIE AVE |
| Street Address 2 Of The Provider | STE 304 |
| City Of The Provider | ELIZABETHTOWN |
| Zip Code Of The Provider | 427012520 |
| State Code Of The Provider | KY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 55 |
| Number Of Services | 3905 |
| Number Of Medicare Beneficiaries | 655 |
| Total Submitted Charge Amount | 340920 |
| Total Medicare Allowed Amount | 276791.86 |
| Total Medicare Payment Amount | 203652.6 |
| Total Medicare Standardized Payment Amount | 218930.03 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 331 |
| Number Of Medicare Beneficiaries With Drug Services | 274 |
| Total Drug Submitted ChargeAmount | 10475 |
| Total Drug Medicare AllowedAmount | 7865.42 |
| Total Drug Medicare PaymentAmount | 7660.28 |
| Total Drug Medicare Standardized Payment Amount | 7660.28 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 51 |
| Number Of Medical Services | 3574 |
| Number Of Medicare Beneficiaries With Medical Services | 655 |
| Total Medical Submitted Charge Amount | 330445 |
| Total Medical Medicare Allowed Amount | 268926.44 |
| Total Medical Medicare Payment Amount | 195992.32 |
| Total Medical Medicare Standardized Payment Amount | 211269.75 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 59 |
| Number Of Beneficiaries Age 65 to 74 | 248 |
| Number Of Beneficiaries Age 75 to 84 | 231 |
| Number Of Beneficiaries Age Greater 84 | 117 |
| Number Of Female Beneficiaries | 383 |
| Number Of Male Beneficiaries | 272 |
| Number Of Non Hispanic White Beneficiaries | 634 |
| 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 | 575 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 80 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.2211 |