| National Provider Identifier [NPI]: | 1174781025 |
| Last Name Of The Provider | BORAK |
| First Name Of The Provider | SAMUEL |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 619 19TH ST S |
| Street Address 2 Of The Provider | |
| City Of The Provider | BIRMINGHAM |
| Zip Code Of The Provider | 352491900 |
| State Code Of The Provider | AL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pathology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 33 |
| Number Of Services | 1620 |
| Number Of Medicare Beneficiaries | 809 |
| Total Submitted Charge Amount | 379285.06 |
| Total Medicare Allowed Amount | 63670.7 |
| Total Medicare Payment Amount | 48465.21 |
| Total Medicare Standardized Payment Amount | 45696.55 |
| 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 | 33 |
| Number Of Medical Services | 1620 |
| Number Of Medicare Beneficiaries With Medical Services | 809 |
| Total Medical Submitted Charge Amount | 379285.06 |
| Total Medical Medicare Allowed Amount | 63670.7 |
| Total Medical Medicare Payment Amount | 48465.21 |
| Total Medical Medicare Standardized Payment Amount | 45696.55 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 176 |
| Number Of Beneficiaries Age 65 to 74 | 353 |
| Number Of Beneficiaries Age 75 to 84 | 204 |
| Number Of Beneficiaries Age Greater 84 | 76 |
| Number Of Female Beneficiaries | 478 |
| Number Of Male Beneficiaries | 331 |
| Number Of Non Hispanic White Beneficiaries | 564 |
| 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 | 636 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 173 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 24 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.4387 |