| National Provider Identifier [NPI]: | 1649384116 |
| Last Name Of The Provider | GODSEY |
| First Name Of The Provider | KENNETH |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4708 ALLIANCE BLVD STE 300 |
| Street Address 2 Of The Provider | BAYLOR MEDICAL PLAZA 1 |
| City Of The Provider | PLANO |
| Zip Code Of The Provider | 750935339 |
| 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 | 88 |
| Number Of Services | 7809 |
| Number Of Medicare Beneficiaries | 875 |
| Total Submitted Charge Amount | 571305.44 |
| Total Medicare Allowed Amount | 260911.89 |
| Total Medicare Payment Amount | 181579.13 |
| Total Medicare Standardized Payment Amount | 194798.36 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 15 |
| Number Of Drug Services | 3633 |
| Number Of Medicare Beneficiaries With Drug Services | 172 |
| Total Drug Submitted ChargeAmount | 82837.5 |
| Total Drug Medicare AllowedAmount | 21090.81 |
| Total Drug Medicare PaymentAmount | 17287.26 |
| Total Drug Medicare Standardized Payment Amount | 17287.26 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 73 |
| Number Of Medical Services | 4176 |
| Number Of Medicare Beneficiaries With Medical Services | 875 |
| Total Medical Submitted Charge Amount | 488467.94 |
| Total Medical Medicare Allowed Amount | 239821.08 |
| Total Medical Medicare Payment Amount | 164291.87 |
| Total Medical Medicare Standardized Payment Amount | 177511.1 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 19 |
| Number Of Beneficiaries Age 65 to 74 | 462 |
| Number Of Beneficiaries Age 75 to 84 | 293 |
| Number Of Beneficiaries Age Greater 84 | 101 |
| Number Of Female Beneficiaries | 408 |
| Number Of Male Beneficiaries | 467 |
| Number Of Non Hispanic White Beneficiaries | 806 |
| Number Of Black or African American Beneficiaries | 16 |
| Number Of AsianPacific Islander Beneficiaries | 19 |
| Number Of Hispanic Beneficiaries | 22 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 12 |
| Number Of Beneficiaries With Medicare Only Entitlement | 862 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 13 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 10 |
| Percent Of With Diabetes | 21 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 28 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 0.8631 |