| National Provider Identifier [NPI]: | 1063443653 |
| Last Name Of The Provider | GOSS |
| First Name Of The Provider | SAMUEL |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1879 NIGHTINGALE LANE |
| Street Address 2 Of The Provider | SUITE C1 |
| City Of The Provider | TAVARES |
| Zip Code Of The Provider | 32778 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 70 |
| Number Of Services | 11149 |
| Number Of Medicare Beneficiaries | 2780 |
| Total Submitted Charge Amount | 1706033.5 |
| Total Medicare Allowed Amount | 1212782.37 |
| Total Medicare Payment Amount | 930291.69 |
| Total Medicare Standardized Payment Amount | 940270.61 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 934 |
| Number Of Medicare Beneficiaries With Drug Services | 235 |
| Total Drug Submitted ChargeAmount | 50202.5 |
| Total Drug Medicare AllowedAmount | 49446.8 |
| Total Drug Medicare PaymentAmount | 38539.18 |
| Total Drug Medicare Standardized Payment Amount | 38539.18 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 69 |
| Number Of Medical Services | 10215 |
| Number Of Medicare Beneficiaries With Medical Services | 2780 |
| Total Medical Submitted Charge Amount | 1655831 |
| Total Medical Medicare Allowed Amount | 1163335.57 |
| Total Medical Medicare Payment Amount | 891752.51 |
| Total Medical Medicare Standardized Payment Amount | 901731.43 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 128 |
| Number Of Beneficiaries Age 65 to 74 | 918 |
| Number Of Beneficiaries Age 75 to 84 | 1176 |
| Number Of Beneficiaries Age Greater 84 | 558 |
| Number Of Female Beneficiaries | 1315 |
| Number Of Male Beneficiaries | 1465 |
| Number Of Non Hispanic White Beneficiaries | 2622 |
| Number Of Black or African American Beneficiaries | 88 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 43 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2526 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 254 |
| Percent Of With Atrial Fibrillation | 44 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 35 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.5754 |