| National Provider Identifier [NPI]: | 1346462702 |
| Last Name Of The Provider | BOURNE |
| First Name Of The Provider | ANDREW |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 455 N SIOUX POINT RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | DAKOTA DUNES |
| Zip Code Of The Provider | 570495327 |
| State Code Of The Provider | SD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 148 |
| Number Of Services | 19233 |
| Number Of Medicare Beneficiaries | 933 |
| Total Submitted Charge Amount | 1245032.5 |
| Total Medicare Allowed Amount | 515802.13 |
| Total Medicare Payment Amount | 392552.58 |
| Total Medicare Standardized Payment Amount | 403053.19 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 15238 |
| Number Of Medicare Beneficiaries With Drug Services | 94 |
| Total Drug Submitted ChargeAmount | 329396 |
| Total Drug Medicare AllowedAmount | 211174.69 |
| Total Drug Medicare PaymentAmount | 164733.23 |
| Total Drug Medicare Standardized Payment Amount | 164733.23 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 139 |
| Number Of Medical Services | 3995 |
| Number Of Medicare Beneficiaries With Medical Services | 933 |
| Total Medical Submitted Charge Amount | 915636.5 |
| Total Medical Medicare Allowed Amount | 304627.44 |
| Total Medical Medicare Payment Amount | 227819.35 |
| Total Medical Medicare Standardized Payment Amount | 238319.96 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 79 |
| Number Of Beneficiaries Age 65 to 74 | 365 |
| Number Of Beneficiaries Age 75 to 84 | 317 |
| Number Of Beneficiaries Age Greater 84 | 172 |
| Number Of Female Beneficiaries | 228 |
| Number Of Male Beneficiaries | 705 |
| Number Of Non Hispanic White Beneficiaries | 892 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 14 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 799 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 134 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 27 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.2443 |