| National Provider Identifier [NPI]: | 1093788523 |
| Last Name Of The Provider | BOOTH |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1301 VETERANS MEMORIAL BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | EUPORA |
| Zip Code Of The Provider | 397442064 |
| State Code Of The Provider | MS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 144 |
| Number Of Services | 17776 |
| Number Of Medicare Beneficiaries | 1220 |
| Total Submitted Charge Amount | 791455 |
| Total Medicare Allowed Amount | 520109.3 |
| Total Medicare Payment Amount | 365388.05 |
| Total Medicare Standardized Payment Amount | 404805.45 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 23 |
| Number Of Drug Services | 4659 |
| Number Of Medicare Beneficiaries With Drug Services | 751 |
| Total Drug Submitted ChargeAmount | 31817 |
| Total Drug Medicare AllowedAmount | 13208.71 |
| Total Drug Medicare PaymentAmount | 10858.86 |
| Total Drug Medicare Standardized Payment Amount | 10858.86 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 121 |
| Number Of Medical Services | 13117 |
| Number Of Medicare Beneficiaries With Medical Services | 1219 |
| Total Medical Submitted Charge Amount | 759638 |
| Total Medical Medicare Allowed Amount | 506900.59 |
| Total Medical Medicare Payment Amount | 354529.19 |
| Total Medical Medicare Standardized Payment Amount | 393946.59 |
| Average Age Of Beneficiaries | 66 |
| Number Of Beneficiaries Age Less65 | 478 |
| Number Of Beneficiaries Age 65 to 74 | 387 |
| Number Of Beneficiaries Age 75 to 84 | 250 |
| Number Of Beneficiaries Age Greater 84 | 105 |
| Number Of Female Beneficiaries | 653 |
| Number Of Male Beneficiaries | 567 |
| Number Of Non Hispanic White Beneficiaries | 857 |
| Number Of Black or African American Beneficiaries | 351 |
| 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 | 590 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 630 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 23 |
| Percent Of With Hypertension | 60 |
| Percent Of With Ischemic Heart Disease | 28 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.112 |