| National Provider Identifier [NPI]: | 1609813831 |
| Last Name Of The Provider | GIAUQUE |
| First Name Of The Provider | ANTHONY |
| 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 | 1055 N CURTIS RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | BOISE |
| Zip Code Of The Provider | 837061309 |
| State Code Of The Provider | ID |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 227 |
| Number Of Services | 9470 |
| Number Of Medicare Beneficiaries | 2490 |
| Total Submitted Charge Amount | 502775.01 |
| Total Medicare Allowed Amount | 212419.24 |
| Total Medicare Payment Amount | 157838.54 |
| Total Medicare Standardized Payment Amount | 173970.42 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 12 |
| Number Of Drug Services | 5905 |
| Number Of Medicare Beneficiaries With Drug Services | 121 |
| Total Drug Submitted ChargeAmount | 3612.37 |
| Total Drug Medicare AllowedAmount | 3257.94 |
| Total Drug Medicare PaymentAmount | 2502.65 |
| Total Drug Medicare Standardized Payment Amount | 2502.65 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 215 |
| Number Of Medical Services | 3565 |
| Number Of Medicare Beneficiaries With Medical Services | 2489 |
| Total Medical Submitted Charge Amount | 499162.64 |
| Total Medical Medicare Allowed Amount | 209161.3 |
| Total Medical Medicare Payment Amount | 155335.89 |
| Total Medical Medicare Standardized Payment Amount | 171467.77 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 568 |
| Number Of Beneficiaries Age 65 to 74 | 815 |
| Number Of Beneficiaries Age 75 to 84 | 715 |
| Number Of Beneficiaries Age Greater 84 | 392 |
| Number Of Female Beneficiaries | 1424 |
| Number Of Male Beneficiaries | 1066 |
| Number Of Non Hispanic White Beneficiaries | 2250 |
| Number Of Black or African American Beneficiaries | 12 |
| Number Of AsianPacific Islander Beneficiaries | 23 |
| Number Of Hispanic Beneficiaries | 160 |
| Number Of American Indian Alaska Native Beneficiaries | 22 |
| Number Of Beneficiaries With Race Not Else where Classified | 23 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1707 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 783 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 38 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.5666 |