| National Provider Identifier [NPI]: | 1811952237 |
| Last Name Of The Provider | MANYAM |
| First Name Of The Provider | BOSE |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5606 W NORVELL BRYANT HWY |
| Street Address 2 Of The Provider | |
| City Of The Provider | CRYSTAL RIVER |
| Zip Code Of The Provider | 344297572 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 48 |
| Number Of Services | 4482 |
| Number Of Medicare Beneficiaries | 1299 |
| Total Submitted Charge Amount | 912154 |
| Total Medicare Allowed Amount | 393157.81 |
| Total Medicare Payment Amount | 294381.63 |
| Total Medicare Standardized Payment Amount | 296061.9 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 330 |
| Number Of Medicare Beneficiaries With Drug Services | 76 |
| Total Drug Submitted ChargeAmount | 34359 |
| Total Drug Medicare AllowedAmount | 15983.05 |
| Total Drug Medicare PaymentAmount | 12530.62 |
| Total Drug Medicare Standardized Payment Amount | 12530.62 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 46 |
| Number Of Medical Services | 4152 |
| Number Of Medicare Beneficiaries With Medical Services | 1299 |
| Total Medical Submitted Charge Amount | 877795 |
| Total Medical Medicare Allowed Amount | 377174.76 |
| Total Medical Medicare Payment Amount | 281851.01 |
| Total Medical Medicare Standardized Payment Amount | 283531.28 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 93 |
| Number Of Beneficiaries Age 65 to 74 | 428 |
| Number Of Beneficiaries Age 75 to 84 | 524 |
| Number Of Beneficiaries Age Greater 84 | 254 |
| Number Of Female Beneficiaries | 625 |
| Number Of Male Beneficiaries | 674 |
| Number Of Non Hispanic White Beneficiaries | 1222 |
| Number Of Black or African American Beneficiaries | 25 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 31 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1126 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 173 |
| Percent Of With Atrial Fibrillation | 33 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 41 |
| Percent Of With Chronic Kidney Disease | 45 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 33 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 16 |
| Average HCC Risk Score Of Beneficiaries | 1.6112 |