National Provider Identifier [NPI]: |
1174620512 |
Last Name Of The Provider |
BOX |
First Name Of The Provider |
LYNDON |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
300 E JEFFERSON ST |
Street Address 2 Of The Provider |
STE 101 |
City Of The Provider |
BOISE |
Zip Code Of The Provider |
837126246 |
State Code Of The Provider |
ID |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
56 |
Number Of Services |
2243 |
Number Of Medicare Beneficiaries |
1280 |
Total Submitted Charge Amount |
283273 |
Total Medicare Allowed Amount |
139085.51 |
Total Medicare Payment Amount |
102022.31 |
Total Medicare Standardized Payment Amount |
110768.29 |
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 |
56 |
Number Of Medical Services |
2243 |
Number Of Medicare Beneficiaries With Medical Services |
1280 |
Total Medical Submitted Charge Amount |
283273 |
Total Medical Medicare Allowed Amount |
139085.51 |
Total Medical Medicare Payment Amount |
102022.31 |
Total Medical Medicare Standardized Payment Amount |
110768.29 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
183 |
Number Of Beneficiaries Age 65 to 74 |
468 |
Number Of Beneficiaries Age 75 to 84 |
422 |
Number Of Beneficiaries Age Greater 84 |
207 |
Number Of Female Beneficiaries |
684 |
Number Of Male Beneficiaries |
596 |
Number Of Non Hispanic White Beneficiaries |
1204 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
42 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
13 |
Number Of Beneficiaries With Medicare Only Entitlement |
1035 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
245 |
Percent Of With Atrial Fibrillation |
26 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
33 |
Percent Of With Chronic Kidney Disease |
36 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
50 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.5454 |