| National Provider Identifier [NPI]: | 1548424385 |
| Last Name Of The Provider | BOOTH |
| First Name Of The Provider | KATRINA |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1530 3RD AVE S |
| Street Address 2 Of The Provider | CH 19, ROOM 201 |
| City Of The Provider | BIRMINGHAM |
| Zip Code Of The Provider | 352942041 |
| State Code Of The Provider | AL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Geriatric Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 19 |
| Number Of Services | 474 |
| Number Of Medicare Beneficiaries | 220 |
| Total Submitted Charge Amount | 139212 |
| Total Medicare Allowed Amount | 49038.93 |
| Total Medicare Payment Amount | 38162.16 |
| Total Medicare Standardized Payment Amount | 40500.59 |
| 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 | 19 |
| Number Of Medical Services | 474 |
| Number Of Medicare Beneficiaries With Medical Services | 220 |
| Total Medical Submitted Charge Amount | 139212 |
| Total Medical Medicare Allowed Amount | 49038.93 |
| Total Medical Medicare Payment Amount | 38162.16 |
| Total Medical Medicare Standardized Payment Amount | 40500.59 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 13 |
| Number Of Beneficiaries Age 65 to 74 | 53 |
| Number Of Beneficiaries Age 75 to 84 | 96 |
| Number Of Beneficiaries Age Greater 84 | 58 |
| Number Of Female Beneficiaries | 138 |
| Number Of Male Beneficiaries | 82 |
| Number Of Non Hispanic White Beneficiaries | 158 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 168 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 52 |
| Percent Of With Atrial Fibrillation | 27 |
| Percent Of With Alzheimers Disease or Dementia | 60 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 49 |
| Percent Of With Chronic Kidney Disease | 64 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 50 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 60 |
| Percent Of With Osteoporosis | 24 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 61 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 22 |
| Percent Of With Stroke | 20 |
| Average HCC Risk Score Of Beneficiaries | 2.0579 |