| National Provider Identifier [NPI]: | 1316935034 |
| Last Name Of The Provider | BOOLBOL |
| First Name Of The Provider | ROBERT |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 11 SOUTH RD |
| Street Address 2 Of The Provider | SUITE 250 |
| City Of The Provider | FARMINGTON |
| Zip Code Of The Provider | 060322483 |
| State Code Of The Provider | CT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Interventional Pain Management |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 68 |
| Number Of Services | 17238 |
| Number Of Medicare Beneficiaries | 853 |
| Total Submitted Charge Amount | 4841403.89 |
| Total Medicare Allowed Amount | 1031736.45 |
| Total Medicare Payment Amount | 794940.49 |
| Total Medicare Standardized Payment Amount | 689249.88 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 4210 |
| Number Of Medicare Beneficiaries With Drug Services | 451 |
| Total Drug Submitted ChargeAmount | 67865 |
| Total Drug Medicare AllowedAmount | 12870.53 |
| Total Drug Medicare PaymentAmount | 9108.76 |
| Total Drug Medicare Standardized Payment Amount | 9108.76 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 60 |
| Number Of Medical Services | 13028 |
| Number Of Medicare Beneficiaries With Medical Services | 853 |
| Total Medical Submitted Charge Amount | 4773538.89 |
| Total Medical Medicare Allowed Amount | 1018865.92 |
| Total Medical Medicare Payment Amount | 785831.73 |
| Total Medical Medicare Standardized Payment Amount | 680141.12 |
| Average Age Of Beneficiaries | 61 |
| Number Of Beneficiaries Age Less65 | 528 |
| Number Of Beneficiaries Age 65 to 74 | 195 |
| Number Of Beneficiaries Age 75 to 84 | 91 |
| Number Of Beneficiaries Age Greater 84 | 39 |
| Number Of Female Beneficiaries | 518 |
| Number Of Male Beneficiaries | 335 |
| Number Of Non Hispanic White Beneficiaries | 681 |
| Number Of Black or African American Beneficiaries | 75 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 79 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 443 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 410 |
| Percent Of With Atrial Fibrillation | 5 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 45 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 54 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.3522 |