| National Provider Identifier [NPI]: | 1548240039 |
| Last Name Of The Provider | GOOS |
| First Name Of The Provider | SAMUEL |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 86 BAKER AVENUE EXT |
| Street Address 2 Of The Provider | SUITE 302 |
| City Of The Provider | CONCORD |
| Zip Code Of The Provider | 017422132 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 62 |
| Number Of Services | 7653 |
| Number Of Medicare Beneficiaries | 2215 |
| Total Submitted Charge Amount | 920827 |
| Total Medicare Allowed Amount | 339522.03 |
| Total Medicare Payment Amount | 243298.49 |
| Total Medicare Standardized Payment Amount | 200518.45 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 901 |
| Number Of Medicare Beneficiaries With Drug Services | 13 |
| Total Drug Submitted ChargeAmount | 8437 |
| Total Drug Medicare AllowedAmount | 5133.25 |
| Total Drug Medicare PaymentAmount | 4024.46 |
| Total Drug Medicare Standardized Payment Amount | 4024.46 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 59 |
| Number Of Medical Services | 6752 |
| Number Of Medicare Beneficiaries With Medical Services | 2215 |
| Total Medical Submitted Charge Amount | 912390 |
| Total Medical Medicare Allowed Amount | 334388.78 |
| Total Medical Medicare Payment Amount | 239274.03 |
| Total Medical Medicare Standardized Payment Amount | 196493.99 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 79 |
| Number Of Beneficiaries Age 65 to 74 | 964 |
| Number Of Beneficiaries Age 75 to 84 | 802 |
| Number Of Beneficiaries Age Greater 84 | 370 |
| Number Of Female Beneficiaries | 1123 |
| Number Of Male Beneficiaries | 1092 |
| Number Of Non Hispanic White Beneficiaries | 2156 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 19 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 27 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2135 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 80 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 19 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 58 |
| Percent Of With Ischemic Heart Disease | 28 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.9492 |