| National Provider Identifier [NPI]: | 1902919293 |
| Last Name Of The Provider | GOODEMOTE |
| First Name Of The Provider | KIMBERLY |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 907 E LAMAR ALEXANDER PKWY |
| Street Address 2 Of The Provider | |
| City Of The Provider | MARYVILLE |
| Zip Code Of The Provider | 378045015 |
| 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 | 70 |
| Number Of Services | 1791 |
| Number Of Medicare Beneficiaries | 688 |
| Total Submitted Charge Amount | 168778 |
| Total Medicare Allowed Amount | 118620.31 |
| Total Medicare Payment Amount | 87368.76 |
| Total Medicare Standardized Payment Amount | 94814.89 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 13 |
| Number Of Drug Services | 402 |
| Number Of Medicare Beneficiaries With Drug Services | 81 |
| Total Drug Submitted ChargeAmount | 3696 |
| Total Drug Medicare AllowedAmount | 445.6 |
| Total Drug Medicare PaymentAmount | 385.17 |
| Total Drug Medicare Standardized Payment Amount | 385.17 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 57 |
| Number Of Medical Services | 1389 |
| Number Of Medicare Beneficiaries With Medical Services | 687 |
| Total Medical Submitted Charge Amount | 165082 |
| Total Medical Medicare Allowed Amount | 118174.71 |
| Total Medical Medicare Payment Amount | 86983.59 |
| Total Medical Medicare Standardized Payment Amount | 94429.72 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 207 |
| Number Of Beneficiaries Age 65 to 74 | 237 |
| Number Of Beneficiaries Age 75 to 84 | 147 |
| Number Of Beneficiaries Age Greater 84 | 97 |
| Number Of Female Beneficiaries | 413 |
| Number Of Male Beneficiaries | 275 |
| Number Of Non Hispanic White Beneficiaries | 648 |
| Number Of Black or African American Beneficiaries | 26 |
| 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 | 456 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 232 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 35 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.7351 |