| National Provider Identifier [NPI]: | 1063576130 |
| Last Name Of The Provider | BOLEN |
| First Name Of The Provider | JOEL |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1230 CARMICHAEL WAY |
| Street Address 2 Of The Provider | |
| City Of The Provider | MONTGOMERY |
| Zip Code Of The Provider | 361063671 |
| State Code Of The Provider | AL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 77 |
| Number Of Services | 5385 |
| Number Of Medicare Beneficiaries | 960 |
| Total Submitted Charge Amount | 522565 |
| Total Medicare Allowed Amount | 423875.32 |
| Total Medicare Payment Amount | 308882.55 |
| Total Medicare Standardized Payment Amount | 340516.65 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 246 |
| Number Of Medicare Beneficiaries With Drug Services | 212 |
| Total Drug Submitted ChargeAmount | 6116 |
| Total Drug Medicare AllowedAmount | 4832.09 |
| Total Drug Medicare PaymentAmount | 4719.36 |
| Total Drug Medicare Standardized Payment Amount | 4719.36 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 69 |
| Number Of Medical Services | 5139 |
| Number Of Medicare Beneficiaries With Medical Services | 960 |
| Total Medical Submitted Charge Amount | 516449 |
| Total Medical Medicare Allowed Amount | 419043.23 |
| Total Medical Medicare Payment Amount | 304163.19 |
| Total Medical Medicare Standardized Payment Amount | 335797.29 |
| Average Age Of Beneficiaries | 80 |
| Number Of Beneficiaries Age Less65 | 60 |
| Number Of Beneficiaries Age 65 to 74 | 186 |
| Number Of Beneficiaries Age 75 to 84 | 365 |
| Number Of Beneficiaries Age Greater 84 | 349 |
| Number Of Female Beneficiaries | 695 |
| Number Of Male Beneficiaries | 265 |
| Number Of Non Hispanic White Beneficiaries | 650 |
| 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 | 627 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 333 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 52 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 36 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 19 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 72 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 19 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.6906 |