| National Provider Identifier [NPI]: | 1942224035 |
| Last Name Of The Provider | GODARD |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 158 CLINIC AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | CARROLLTON |
| Zip Code Of The Provider | 301174414 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 32 |
| Number Of Services | 1687 |
| Number Of Medicare Beneficiaries | 944 |
| Total Submitted Charge Amount | 232738 |
| Total Medicare Allowed Amount | 157990.94 |
| Total Medicare Payment Amount | 106102.8 |
| Total Medicare Standardized Payment Amount | 115065.38 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 32 |
| Number Of Medical Services | 1687 |
| Number Of Medicare Beneficiaries With Medical Services | 944 |
| Total Medical Submitted Charge Amount | 232738 |
| Total Medical Medicare Allowed Amount | 157990.94 |
| Total Medical Medicare Payment Amount | 106102.8 |
| Total Medical Medicare Standardized Payment Amount | 115065.38 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 50 |
| Number Of Beneficiaries Age 65 to 74 | 359 |
| Number Of Beneficiaries Age 75 to 84 | 369 |
| Number Of Beneficiaries Age Greater 84 | 166 |
| Number Of Female Beneficiaries | 573 |
| Number Of Male Beneficiaries | 371 |
| Number Of Non Hispanic White Beneficiaries | 859 |
| Number Of Black or African American Beneficiaries | 63 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 11 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 810 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 134 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.0638 |