| National Provider Identifier [NPI]: | 1972620797 |
| Last Name Of The Provider | BOLTON |
| First Name Of The Provider | GARY |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | M. D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 305 HIGHLAND PARK CV |
| Street Address 2 Of The Provider | |
| City Of The Provider | RIDGELAND |
| Zip Code Of The Provider | 391576059 |
| State Code Of The Provider | MS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 35 |
| Number Of Services | 4391 |
| Number Of Medicare Beneficiaries | 1045 |
| Total Submitted Charge Amount | 216441.88 |
| Total Medicare Allowed Amount | 187830.37 |
| Total Medicare Payment Amount | 126791.57 |
| Total Medicare Standardized Payment Amount | 143555.43 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 35 |
| Number Of Medical Services | 4391 |
| Number Of Medicare Beneficiaries With Medical Services | 1045 |
| Total Medical Submitted Charge Amount | 216441.88 |
| Total Medical Medicare Allowed Amount | 187830.37 |
| Total Medical Medicare Payment Amount | 126791.57 |
| Total Medical Medicare Standardized Payment Amount | 143555.43 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 31 |
| Number Of Beneficiaries Age 65 to 74 | 474 |
| Number Of Beneficiaries Age 75 to 84 | 410 |
| Number Of Beneficiaries Age Greater 84 | 130 |
| Number Of Female Beneficiaries | 480 |
| Number Of Male Beneficiaries | 565 |
| Number Of Non Hispanic White Beneficiaries | 1004 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1007 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 38 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 9 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 10 |
| Percent Of With Diabetes | 21 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 28 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.884 |