| National Provider Identifier [NPI]: | 1538157334 |
| Last Name Of The Provider | BOATWRIGHT |
| First Name Of The Provider | STEPHEN |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4736 HIGHWAY 17 BYP S |
| Street Address 2 Of The Provider | |
| City Of The Provider | MYRTLE BEACH |
| Zip Code Of The Provider | 295885616 |
| State Code Of The Provider | SC |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Anesthesiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 57 |
| Number Of Services | 4172 |
| Number Of Medicare Beneficiaries | 656 |
| Total Submitted Charge Amount | 799647 |
| Total Medicare Allowed Amount | 352929.02 |
| Total Medicare Payment Amount | 254125.35 |
| Total Medicare Standardized Payment Amount | 273162.45 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 937 |
| Number Of Medicare Beneficiaries With Drug Services | 277 |
| Total Drug Submitted ChargeAmount | 20993 |
| Total Drug Medicare AllowedAmount | 6928.07 |
| Total Drug Medicare PaymentAmount | 5384.24 |
| Total Drug Medicare Standardized Payment Amount | 5384.24 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 47 |
| Number Of Medical Services | 3235 |
| Number Of Medicare Beneficiaries With Medical Services | 656 |
| Total Medical Submitted Charge Amount | 778654 |
| Total Medical Medicare Allowed Amount | 346000.95 |
| Total Medical Medicare Payment Amount | 248741.11 |
| Total Medical Medicare Standardized Payment Amount | 267778.21 |
| Average Age Of Beneficiaries | 64 |
| Number Of Beneficiaries Age Less65 | 280 |
| Number Of Beneficiaries Age 65 to 74 | 266 |
| Number Of Beneficiaries Age 75 to 84 | 94 |
| Number Of Beneficiaries Age Greater 84 | 16 |
| Number Of Female Beneficiaries | 368 |
| Number Of Male Beneficiaries | 288 |
| Number Of Non Hispanic White Beneficiaries | 596 |
| Number Of Black or African American Beneficiaries | 47 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 478 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 178 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 28 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.0987 |