| National Provider Identifier [NPI]: | 1518055854 |
| Last Name Of The Provider | GOSWAMI |
| First Name Of The Provider | KETAN |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 758 OLD NORCROSS RD |
| Street Address 2 Of The Provider | SUITE 175 |
| City Of The Provider | LAWRENCEVILLE |
| Zip Code Of The Provider | 300453385 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Endocrinology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 32 |
| Number Of Services | 3793 |
| Number Of Medicare Beneficiaries | 577 |
| Total Submitted Charge Amount | 373482 |
| Total Medicare Allowed Amount | 173351.4 |
| Total Medicare Payment Amount | 122581.48 |
| Total Medicare Standardized Payment Amount | 128126.53 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 104 |
| Number Of Medicare Beneficiaries With Drug Services | 35 |
| Total Drug Submitted ChargeAmount | 2478 |
| Total Drug Medicare AllowedAmount | 1071.97 |
| Total Drug Medicare PaymentAmount | 892.16 |
| Total Drug Medicare Standardized Payment Amount | 892.16 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 27 |
| Number Of Medical Services | 3689 |
| Number Of Medicare Beneficiaries With Medical Services | 577 |
| Total Medical Submitted Charge Amount | 371004 |
| Total Medical Medicare Allowed Amount | 172279.43 |
| Total Medical Medicare Payment Amount | 121689.32 |
| Total Medical Medicare Standardized Payment Amount | 127234.37 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 109 |
| Number Of Beneficiaries Age 65 to 74 | 311 |
| Number Of Beneficiaries Age 75 to 84 | 120 |
| Number Of Beneficiaries Age Greater 84 | 37 |
| Number Of Female Beneficiaries | 345 |
| Number Of Male Beneficiaries | 232 |
| Number Of Non Hispanic White Beneficiaries | 386 |
| Number Of Black or African American Beneficiaries | 118 |
| Number Of AsianPacific Islander Beneficiaries | 34 |
| Number Of Hispanic Beneficiaries | 25 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 14 |
| Number Of Beneficiaries With Medicare Only Entitlement | 484 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 93 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 75 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.5267 |