| National Provider Identifier [NPI]: | 1407838188 |
| Last Name Of The Provider | GODIWALA |
| First Name Of The Provider | SUNITA |
| Middle Initial Of The Provider | N |
| Credentials Of The Provider | M.D., FAAFP. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 11 MAYO DR |
| Street Address 2 Of The Provider | UNIT-B |
| City Of The Provider | HOLDEN |
| Zip Code Of The Provider | 015201539 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 18 |
| Number Of Services | 1944 |
| Number Of Medicare Beneficiaries | 666 |
| Total Submitted Charge Amount | 392045 |
| Total Medicare Allowed Amount | 201384.25 |
| Total Medicare Payment Amount | 144133.82 |
| Total Medicare Standardized Payment Amount | 126702.27 |
| 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 | 18 |
| Number Of Medical Services | 1944 |
| Number Of Medicare Beneficiaries With Medical Services | 666 |
| Total Medical Submitted Charge Amount | 392045 |
| Total Medical Medicare Allowed Amount | 201384.25 |
| Total Medical Medicare Payment Amount | 144133.82 |
| Total Medical Medicare Standardized Payment Amount | 126702.27 |
| Average Age Of Beneficiaries | 57 |
| Number Of Beneficiaries Age Less65 | 435 |
| Number Of Beneficiaries Age 65 to 74 | 134 |
| Number Of Beneficiaries Age 75 to 84 | 60 |
| Number Of Beneficiaries Age Greater 84 | 37 |
| Number Of Female Beneficiaries | 287 |
| Number Of Male Beneficiaries | 379 |
| Number Of Non Hispanic White Beneficiaries | 546 |
| Number Of Black or African American Beneficiaries | 47 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 58 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 239 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 427 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 22 |
| Percent Of With Cancer | 5 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 67 |
| Percent Of With Diabetes | 21 |
| Percent Of With Hyperlipidemia | 43 |
| Percent Of With Hypertension | 58 |
| Percent Of With Ischemic Heart Disease | 23 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 22 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.6969 |