| National Provider Identifier [NPI]: | 1477548469 |
| Last Name Of The Provider | GO |
| First Name Of The Provider | ROMMEL |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3442 US HIGHWAY 431 |
| Street Address 2 Of The Provider | |
| City Of The Provider | ALBERTVILLE |
| Zip Code Of The Provider | 359500203 |
| State Code Of The Provider | AL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 98 |
| Number Of Services | 2950 |
| Number Of Medicare Beneficiaries | 1100 |
| Total Submitted Charge Amount | 256667.55 |
| Total Medicare Allowed Amount | 141156.92 |
| Total Medicare Payment Amount | 102222.7 |
| Total Medicare Standardized Payment Amount | 120512.76 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 175 |
| Number Of Medicare Beneficiaries With Drug Services | 60 |
| Total Drug Submitted ChargeAmount | 7105 |
| Total Drug Medicare AllowedAmount | 3700.05 |
| Total Drug Medicare PaymentAmount | 2593.13 |
| Total Drug Medicare Standardized Payment Amount | 2593.13 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 92 |
| Number Of Medical Services | 2775 |
| Number Of Medicare Beneficiaries With Medical Services | 1085 |
| Total Medical Submitted Charge Amount | 249562.55 |
| Total Medical Medicare Allowed Amount | 137456.87 |
| Total Medical Medicare Payment Amount | 99629.57 |
| Total Medical Medicare Standardized Payment Amount | 117919.63 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 415 |
| Number Of Beneficiaries Age 65 to 74 | 367 |
| Number Of Beneficiaries Age 75 to 84 | 221 |
| Number Of Beneficiaries Age Greater 84 | 97 |
| Number Of Female Beneficiaries | 678 |
| Number Of Male Beneficiaries | 422 |
| Number Of Non Hispanic White Beneficiaries | 1053 |
| Number Of Black or African American Beneficiaries | 11 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 24 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 516 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 584 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 35 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 40 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 50 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.4553 |