| National Provider Identifier [NPI]: | 1801909122 |
| Last Name Of The Provider | BECKSTEAD |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 41 NORTH 1 EAST |
| Street Address 2 Of The Provider | |
| City Of The Provider | PRESTON |
| Zip Code Of The Provider | 83263 |
| State Code Of The Provider | ID |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 76 |
| Number Of Services | 5838 |
| Number Of Medicare Beneficiaries | 890 |
| Total Submitted Charge Amount | 427308.9 |
| Total Medicare Allowed Amount | 358609.49 |
| Total Medicare Payment Amount | 245939.2 |
| Total Medicare Standardized Payment Amount | 265916.69 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 788 |
| Number Of Medicare Beneficiaries With Drug Services | 373 |
| Total Drug Submitted ChargeAmount | 16170.72 |
| Total Drug Medicare AllowedAmount | 8793.07 |
| Total Drug Medicare PaymentAmount | 7368.33 |
| Total Drug Medicare Standardized Payment Amount | 7368.33 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 67 |
| Number Of Medical Services | 5050 |
| Number Of Medicare Beneficiaries With Medical Services | 890 |
| Total Medical Submitted Charge Amount | 411138.18 |
| Total Medical Medicare Allowed Amount | 349816.42 |
| Total Medical Medicare Payment Amount | 238570.87 |
| Total Medical Medicare Standardized Payment Amount | 258548.36 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 103 |
| Number Of Beneficiaries Age 65 to 74 | 351 |
| Number Of Beneficiaries Age 75 to 84 | 295 |
| Number Of Beneficiaries Age Greater 84 | 141 |
| Number Of Female Beneficiaries | 462 |
| Number Of Male Beneficiaries | 428 |
| Number Of Non Hispanic White Beneficiaries | 861 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 12 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 778 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 112 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 9 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 28 |
| Percent Of With Hypertension | 42 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | 3 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 2 |
| Average HCC Risk Score Of Beneficiaries | 0.8838 |