| National Provider Identifier [NPI]: | 1861489510 |
| Last Name Of The Provider | BOVA |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2524 FARRAGUT DR |
| Street Address 2 Of The Provider | SUITE C |
| City Of The Provider | SPRINGFIELD |
| Zip Code Of The Provider | 627048400 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 55 |
| Number Of Services | 2734 |
| Number Of Medicare Beneficiaries | 531 |
| Total Submitted Charge Amount | 352459.8 |
| Total Medicare Allowed Amount | 162438.49 |
| Total Medicare Payment Amount | 112656.36 |
| Total Medicare Standardized Payment Amount | 118953.1 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 374 |
| Number Of Medicare Beneficiaries With Drug Services | 146 |
| Total Drug Submitted ChargeAmount | 10269.5 |
| Total Drug Medicare AllowedAmount | 4968.3 |
| Total Drug Medicare PaymentAmount | 4506.86 |
| Total Drug Medicare Standardized Payment Amount | 4506.86 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 49 |
| Number Of Medical Services | 2360 |
| Number Of Medicare Beneficiaries With Medical Services | 531 |
| Total Medical Submitted Charge Amount | 342190.3 |
| Total Medical Medicare Allowed Amount | 157470.19 |
| Total Medical Medicare Payment Amount | 108149.5 |
| Total Medical Medicare Standardized Payment Amount | 114446.24 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 84 |
| Number Of Beneficiaries Age 65 to 74 | 201 |
| Number Of Beneficiaries Age 75 to 84 | 163 |
| Number Of Beneficiaries Age Greater 84 | 83 |
| Number Of Female Beneficiaries | 279 |
| Number Of Male Beneficiaries | 252 |
| Number Of Non Hispanic White Beneficiaries | 491 |
| 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 | 400 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 131 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.4843 |