| National Provider Identifier [NPI]: | 1194750018 |
| Last Name Of The Provider | GOODMAN |
| First Name Of The Provider | LAWRENCE |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 759 CHESTNUT ST |
| Street Address 2 Of The Provider | RADIOLOGY DEPARTMENT |
| City Of The Provider | SPRINGFIELD |
| Zip Code Of The Provider | 011071619 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 97 |
| Number Of Services | 3838 |
| Number Of Medicare Beneficiaries | 2450 |
| Total Submitted Charge Amount | 496032 |
| Total Medicare Allowed Amount | 156851.94 |
| Total Medicare Payment Amount | 126669.78 |
| Total Medicare Standardized Payment Amount | 124355.9 |
| Drug Suppress Indicator | * |
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| Medical SuppressIndicator | # |
| Number Of HCPCS Associated With MedicalServices | |
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| Number Of Medicare Beneficiaries With Medical Services | |
| Total Medical Submitted Charge Amount | |
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| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 522 |
| Number Of Beneficiaries Age 65 to 74 | 888 |
| Number Of Beneficiaries Age 75 to 84 | 658 |
| Number Of Beneficiaries Age Greater 84 | 382 |
| Number Of Female Beneficiaries | 1553 |
| Number Of Male Beneficiaries | 897 |
| Number Of Non Hispanic White Beneficiaries | 1998 |
| Number Of Black or African American Beneficiaries | 162 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 232 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 33 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1589 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 861 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.7434 |