| National Provider Identifier [NPI]: | 1750382040 |
| Last Name Of The Provider | BOARDMAN |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 150 S MOUNT AUBURN RD |
| Street Address 2 Of The Provider | SUITE 418 |
| City Of The Provider | CAPE GIRARDEAU |
| Zip Code Of The Provider | 637034910 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 133 |
| Number Of Services | 16267 |
| Number Of Medicare Beneficiaries | 1057 |
| Total Submitted Charge Amount | 948853 |
| Total Medicare Allowed Amount | 568988.64 |
| Total Medicare Payment Amount | 442565.91 |
| Total Medicare Standardized Payment Amount | 473445.05 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 14 |
| Number Of Drug Services | 905 |
| Number Of Medicare Beneficiaries With Drug Services | 369 |
| Total Drug Submitted ChargeAmount | 36522 |
| Total Drug Medicare AllowedAmount | 24501.91 |
| Total Drug Medicare PaymentAmount | 22718.67 |
| Total Drug Medicare Standardized Payment Amount | 22718.67 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 119 |
| Number Of Medical Services | 15362 |
| Number Of Medicare Beneficiaries With Medical Services | 1057 |
| Total Medical Submitted Charge Amount | 912331 |
| Total Medical Medicare Allowed Amount | 544486.73 |
| Total Medical Medicare Payment Amount | 419847.24 |
| Total Medical Medicare Standardized Payment Amount | 450726.38 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 94 |
| Number Of Beneficiaries Age 65 to 74 | 463 |
| Number Of Beneficiaries Age 75 to 84 | 297 |
| Number Of Beneficiaries Age Greater 84 | 203 |
| Number Of Female Beneficiaries | 665 |
| Number Of Male Beneficiaries | 392 |
| Number Of Non Hispanic White Beneficiaries | 1028 |
| Number Of Black or African American Beneficiaries | 18 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 929 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 128 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 3 |
| 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 | 19 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.0735 |