| National Provider Identifier [NPI]: | 1982651188 |
| Last Name Of The Provider | BOORE |
| First Name Of The Provider | TAMARA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3050 MONTVALE DR STE A |
| Street Address 2 Of The Provider | |
| City Of The Provider | SPRINGFIELD |
| Zip Code Of The Provider | 627046924 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 141 |
| Number Of Services | 5429 |
| Number Of Medicare Beneficiaries | 3963 |
| Total Submitted Charge Amount | 811581.5 |
| Total Medicare Allowed Amount | 129766.36 |
| Total Medicare Payment Amount | 101168.46 |
| Total Medicare Standardized Payment Amount | 102605.25 |
| 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 | 141 |
| Number Of Medical Services | 5429 |
| Number Of Medicare Beneficiaries With Medical Services | 3963 |
| Total Medical Submitted Charge Amount | 811581.5 |
| Total Medical Medicare Allowed Amount | 129766.36 |
| Total Medical Medicare Payment Amount | 101168.46 |
| Total Medical Medicare Standardized Payment Amount | 102605.25 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 730 |
| Number Of Beneficiaries Age 65 to 74 | 1223 |
| Number Of Beneficiaries Age 75 to 84 | 1138 |
| Number Of Beneficiaries Age Greater 84 | 872 |
| Number Of Female Beneficiaries | 2282 |
| Number Of Male Beneficiaries | 1681 |
| Number Of Non Hispanic White Beneficiaries | 3646 |
| Number Of Black or African American Beneficiaries | 257 |
| Number Of AsianPacific Islander Beneficiaries | 13 |
| Number Of Hispanic Beneficiaries | 23 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 24 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2702 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1261 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 38 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 36 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 51 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.6681 |