| National Provider Identifier [NPI]: | 1578504429 |
| Last Name Of The Provider | GOELLNER |
| First Name Of The Provider | WILLIAM |
| 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 | 910 OLD CAMP RD STE 192 |
| Street Address 2 Of The Provider | |
| City Of The Provider | THE VILLAGES |
| Zip Code Of The Provider | 321625605 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 79 |
| Number Of Services | 54045 |
| Number Of Medicare Beneficiaries | 5908 |
| Total Submitted Charge Amount | 3445650 |
| Total Medicare Allowed Amount | 1783047.94 |
| Total Medicare Payment Amount | 1347813.36 |
| Total Medicare Standardized Payment Amount | 1453658.36 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 17 |
| Number Of Drug Services | 29994 |
| Number Of Medicare Beneficiaries With Drug Services | 2712 |
| Total Drug Submitted ChargeAmount | 320843 |
| Total Drug Medicare AllowedAmount | 19427.77 |
| Total Drug Medicare PaymentAmount | 15175.77 |
| Total Drug Medicare Standardized Payment Amount | 15175.77 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 62 |
| Number Of Medical Services | 24051 |
| Number Of Medicare Beneficiaries With Medical Services | 5908 |
| Total Medical Submitted Charge Amount | 3124807 |
| Total Medical Medicare Allowed Amount | 1763620.17 |
| Total Medical Medicare Payment Amount | 1332637.59 |
| Total Medical Medicare Standardized Payment Amount | 1438482.59 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 224 |
| Number Of Beneficiaries Age 65 to 74 | 3093 |
| Number Of Beneficiaries Age 75 to 84 | 2000 |
| Number Of Beneficiaries Age Greater 84 | 591 |
| Number Of Female Beneficiaries | 3490 |
| Number Of Male Beneficiaries | 2418 |
| Number Of Non Hispanic White Beneficiaries | 5708 |
| Number Of Black or African American Beneficiaries | 36 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 77 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 68 |
| Number Of Beneficiaries With Medicare Only Entitlement | 5736 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 172 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 74 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.0292 |