| National Provider Identifier [NPI]: | 1548295587 |
| Last Name Of The Provider | GOHEEN |
| First Name Of The Provider | SUSANNA |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2101 EMRICK BLVD |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | BETHLEHEM |
| Zip Code Of The Provider | 180208040 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 41 |
| Number Of Services | 1326 |
| Number Of Medicare Beneficiaries | 367 |
| Total Submitted Charge Amount | 202301 |
| Total Medicare Allowed Amount | 86663.67 |
| Total Medicare Payment Amount | 63458.46 |
| Total Medicare Standardized Payment Amount | 62698.71 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 221 |
| Number Of Medicare Beneficiaries With Drug Services | 176 |
| Total Drug Submitted ChargeAmount | 14618 |
| Total Drug Medicare AllowedAmount | 9417.28 |
| Total Drug Medicare PaymentAmount | 9206.46 |
| Total Drug Medicare Standardized Payment Amount | 9206.46 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 32 |
| Number Of Medical Services | 1105 |
| Number Of Medicare Beneficiaries With Medical Services | 367 |
| Total Medical Submitted Charge Amount | 187683 |
| Total Medical Medicare Allowed Amount | 77246.39 |
| Total Medical Medicare Payment Amount | 54252 |
| Total Medical Medicare Standardized Payment Amount | 53492.25 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 54 |
| Number Of Beneficiaries Age 65 to 74 | 156 |
| Number Of Beneficiaries Age 75 to 84 | 117 |
| Number Of Beneficiaries Age Greater 84 | 40 |
| Number Of Female Beneficiaries | 223 |
| Number Of Male Beneficiaries | 144 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 316 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 51 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.1128 |