| National Provider Identifier [NPI]: | 1104982453 |
| Last Name Of The Provider | BOVINE |
| First Name Of The Provider | THOMAS |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7794 RHEA COUNTY HWY |
| Street Address 2 Of The Provider | SUITE 101 |
| City Of The Provider | DAYTON |
| Zip Code Of The Provider | 373215981 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 55 |
| Number Of Services | 3131 |
| Number Of Medicare Beneficiaries | 377 |
| Total Submitted Charge Amount | 190657 |
| Total Medicare Allowed Amount | 166938.79 |
| Total Medicare Payment Amount | 117455.2 |
| Total Medicare Standardized Payment Amount | 128200.87 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 276 |
| Number Of Medicare Beneficiaries With Drug Services | 158 |
| Total Drug Submitted ChargeAmount | 5071 |
| Total Drug Medicare AllowedAmount | 4072.55 |
| Total Drug Medicare PaymentAmount | 3808.72 |
| Total Drug Medicare Standardized Payment Amount | 3808.72 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 47 |
| Number Of Medical Services | 2855 |
| Number Of Medicare Beneficiaries With Medical Services | 377 |
| Total Medical Submitted Charge Amount | 185586 |
| Total Medical Medicare Allowed Amount | 162866.24 |
| Total Medical Medicare Payment Amount | 113646.48 |
| Total Medical Medicare Standardized Payment Amount | 124392.15 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 44 |
| Number Of Beneficiaries Age 65 to 74 | 160 |
| Number Of Beneficiaries Age 75 to 84 | 117 |
| Number Of Beneficiaries Age Greater 84 | 56 |
| Number Of Female Beneficiaries | 217 |
| Number Of Male Beneficiaries | 160 |
| Number Of Non Hispanic White Beneficiaries | 365 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| 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 | 271 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 106 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 3 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 39 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.1261 |