| National Provider Identifier [NPI]: | 1992913941 |
| Last Name Of The Provider | GOODWICH |
| First Name Of The Provider | RONALD |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3680 BROADWAY |
| Street Address 2 Of The Provider | |
| City Of The Provider | FORT MYERS |
| Zip Code Of The Provider | 339018005 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 79 |
| Number Of Services | 6890 |
| Number Of Medicare Beneficiaries | 2793 |
| Total Submitted Charge Amount | 2600246.67 |
| Total Medicare Allowed Amount | 1052264.81 |
| Total Medicare Payment Amount | 818493.45 |
| Total Medicare Standardized Payment Amount | 802746.85 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 2269 |
| Number Of Medicare Beneficiaries With Drug Services | 70 |
| Total Drug Submitted ChargeAmount | 11212.11 |
| Total Drug Medicare AllowedAmount | 7807.08 |
| Total Drug Medicare PaymentAmount | 6059.16 |
| Total Drug Medicare Standardized Payment Amount | 6059.16 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 74 |
| Number Of Medical Services | 4621 |
| Number Of Medicare Beneficiaries With Medical Services | 2792 |
| Total Medical Submitted Charge Amount | 2589034.56 |
| Total Medical Medicare Allowed Amount | 1044457.73 |
| Total Medical Medicare Payment Amount | 812434.29 |
| Total Medical Medicare Standardized Payment Amount | 796687.69 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 231 |
| Number Of Beneficiaries Age 65 to 74 | 1213 |
| Number Of Beneficiaries Age 75 to 84 | 1014 |
| Number Of Beneficiaries Age Greater 84 | 335 |
| Number Of Female Beneficiaries | 1464 |
| Number Of Male Beneficiaries | 1329 |
| Number Of Non Hispanic White Beneficiaries | 2450 |
| Number Of Black or African American Beneficiaries | 108 |
| Number Of AsianPacific Islander Beneficiaries | 14 |
| Number Of Hispanic Beneficiaries | 193 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 28 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2414 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 379 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 50 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.9291 |