| National Provider Identifier [NPI]: | 1699734855 |
| Last Name Of The Provider | BOLES |
| First Name Of The Provider | PRESTON |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | DPM |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 309 W CHURCH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | GREENWOOD |
| Zip Code Of The Provider | 389304305 |
| State Code Of The Provider | MS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 34 |
| Number Of Services | 1836 |
| Number Of Medicare Beneficiaries | 857 |
| Total Submitted Charge Amount | 240834.78 |
| Total Medicare Allowed Amount | 96994.53 |
| Total Medicare Payment Amount | 67231.51 |
| Total Medicare Standardized Payment Amount | 74452.96 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 61 |
| Number Of Medicare Beneficiaries With Drug Services | 19 |
| Total Drug Submitted ChargeAmount | 917.78 |
| Total Drug Medicare AllowedAmount | 121.03 |
| Total Drug Medicare PaymentAmount | 84.53 |
| Total Drug Medicare Standardized Payment Amount | 84.53 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 30 |
| Number Of Medical Services | 1775 |
| Number Of Medicare Beneficiaries With Medical Services | 857 |
| Total Medical Submitted Charge Amount | 239917 |
| Total Medical Medicare Allowed Amount | 96873.5 |
| Total Medical Medicare Payment Amount | 67146.98 |
| Total Medical Medicare Standardized Payment Amount | 74368.43 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 191 |
| Number Of Beneficiaries Age 65 to 74 | 287 |
| Number Of Beneficiaries Age 75 to 84 | 240 |
| Number Of Beneficiaries Age Greater 84 | 139 |
| Number Of Female Beneficiaries | 584 |
| Number Of Male Beneficiaries | 273 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | 602 |
| 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 | 390 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 467 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 59 |
| Percent Of With Hyperlipidemia | 42 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 53 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.5267 |