| National Provider Identifier [NPI]: | 1356317747 |
| Last Name Of The Provider | BOLES |
| First Name Of The Provider | SCOTT |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 8745 AERO DRIVE |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | SAN DIEGO |
| Zip Code Of The Provider | 921231774 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 155 |
| Number Of Services | 4911 |
| Number Of Medicare Beneficiaries | 2963 |
| Total Submitted Charge Amount | 432127.4 |
| Total Medicare Allowed Amount | 139539.86 |
| Total Medicare Payment Amount | 98120.56 |
| Total Medicare Standardized Payment Amount | 97610.92 |
| 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 | 155 |
| Number Of Medical Services | 4911 |
| Number Of Medicare Beneficiaries With Medical Services | 2963 |
| Total Medical Submitted Charge Amount | 432127.4 |
| Total Medical Medicare Allowed Amount | 139539.86 |
| Total Medical Medicare Payment Amount | 98120.56 |
| Total Medical Medicare Standardized Payment Amount | 97610.92 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 499 |
| Number Of Beneficiaries Age 65 to 74 | 867 |
| Number Of Beneficiaries Age 75 to 84 | 885 |
| Number Of Beneficiaries Age Greater 84 | 712 |
| Number Of Female Beneficiaries | 1694 |
| Number Of Male Beneficiaries | 1269 |
| Number Of Non Hispanic White Beneficiaries | 1515 |
| Number Of Black or African American Beneficiaries | 162 |
| Number Of AsianPacific Islander Beneficiaries | 315 |
| Number Of Hispanic Beneficiaries | 875 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1562 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1401 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 28 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 50 |
| Percent Of With Chronic Kidney Disease | 49 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 50 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 54 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 2.3748 |