| National Provider Identifier [NPI]: | 1376664532 |
| Last Name Of The Provider | BOATNER |
| First Name Of The Provider | DENISE |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.S., CCC-A |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 618 PEGRAM DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | TUPELO |
| Zip Code Of The Provider | 388016322 |
| State Code Of The Provider | MS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Audiologist (billing independently) |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 13 |
| Number Of Services | 503 |
| Number Of Medicare Beneficiaries | 333 |
| Total Submitted Charge Amount | 36110 |
| Total Medicare Allowed Amount | 14763.27 |
| Total Medicare Payment Amount | 10494.52 |
| Total Medicare Standardized Payment Amount | 11161.09 |
| 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 | 13 |
| Number Of Medical Services | 503 |
| Number Of Medicare Beneficiaries With Medical Services | 333 |
| Total Medical Submitted Charge Amount | 36110 |
| Total Medical Medicare Allowed Amount | 14763.27 |
| Total Medical Medicare Payment Amount | 10494.52 |
| Total Medical Medicare Standardized Payment Amount | 11161.09 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 53 |
| Number Of Beneficiaries Age 65 to 74 | 140 |
| Number Of Beneficiaries Age 75 to 84 | 104 |
| Number Of Beneficiaries Age Greater 84 | 36 |
| Number Of Female Beneficiaries | 213 |
| Number Of Male Beneficiaries | 120 |
| Number Of Non Hispanic White Beneficiaries | 301 |
| 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 | 255 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 78 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.068 |