| National Provider Identifier [NPI]: | 1205925864 |
| Last Name Of The Provider | BOE |
| First Name Of The Provider | JUSTIN |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1408 GLENOLDE PL |
| Street Address 2 Of The Provider | |
| City Of The Provider | EDMOND |
| Zip Code Of The Provider | 730032668 |
| State Code Of The Provider | OK |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 92 |
| Number Of Services | 1575 |
| Number Of Medicare Beneficiaries | 1008 |
| Total Submitted Charge Amount | 278690 |
| Total Medicare Allowed Amount | 55181.07 |
| Total Medicare Payment Amount | 42930.47 |
| Total Medicare Standardized Payment Amount | 46172.38 |
| 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 | 92 |
| Number Of Medical Services | 1575 |
| Number Of Medicare Beneficiaries With Medical Services | 1008 |
| Total Medical Submitted Charge Amount | 278690 |
| Total Medical Medicare Allowed Amount | 55181.07 |
| Total Medical Medicare Payment Amount | 42930.47 |
| Total Medical Medicare Standardized Payment Amount | 46172.38 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 274 |
| Number Of Beneficiaries Age 65 to 74 | 275 |
| Number Of Beneficiaries Age 75 to 84 | 255 |
| Number Of Beneficiaries Age Greater 84 | 204 |
| Number Of Female Beneficiaries | 578 |
| Number Of Male Beneficiaries | 430 |
| Number Of Non Hispanic White Beneficiaries | 781 |
| Number Of Black or African American Beneficiaries | 125 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 47 |
| Number Of American Indian Alaska Native Beneficiaries | 42 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 624 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 384 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 28 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 37 |
| Percent Of With Chronic Kidney Disease | 47 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 32 |
| Percent Of With Depression | 44 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 51 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 13 |
| Percent Of With Stroke | 17 |
| Average HCC Risk Score Of Beneficiaries | 1.9866 |