| National Provider Identifier [NPI]: | 1750360616 |
| Last Name Of The Provider | FOREMAN |
| First Name Of The Provider | BLAIR |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1236 E RUSHOLME ST |
| Street Address 2 Of The Provider | SUITE 300 |
| City Of The Provider | DAVENPORT |
| Zip Code Of The Provider | 528032473 |
| State Code Of The Provider | IA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiac Electrophysiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 100 |
| Number Of Services | 8055 |
| Number Of Medicare Beneficiaries | 1910 |
| Total Submitted Charge Amount | 1293033 |
| Total Medicare Allowed Amount | 542597.49 |
| Total Medicare Payment Amount | 396513.92 |
| Total Medicare Standardized Payment Amount | 433154.03 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 58 |
| Number Of Medicare Beneficiaries With Drug Services | 15 |
| Total Drug Submitted ChargeAmount | 3502 |
| Total Drug Medicare AllowedAmount | 3069.24 |
| Total Drug Medicare PaymentAmount | 2228.51 |
| Total Drug Medicare Standardized Payment Amount | 2228.51 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 98 |
| Number Of Medical Services | 7997 |
| Number Of Medicare Beneficiaries With Medical Services | 1910 |
| Total Medical Submitted Charge Amount | 1289531 |
| Total Medical Medicare Allowed Amount | 539528.25 |
| Total Medical Medicare Payment Amount | 394285.41 |
| Total Medical Medicare Standardized Payment Amount | 430925.52 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 115 |
| Number Of Beneficiaries Age 65 to 74 | 601 |
| Number Of Beneficiaries Age 75 to 84 | 751 |
| Number Of Beneficiaries Age Greater 84 | 443 |
| Number Of Female Beneficiaries | 865 |
| Number Of Male Beneficiaries | 1045 |
| Number Of Non Hispanic White Beneficiaries | 1829 |
| Number Of Black or African American Beneficiaries | 42 |
| 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 | 19 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1722 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 188 |
| Percent Of With Atrial Fibrillation | 52 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 49 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 64 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.6866 |