| National Provider Identifier [NPI]: | 1568469708 |
| Last Name Of The Provider | BOLTON |
| First Name Of The Provider | GEORGE |
| 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 | 3161 L ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | SACRAMENTO |
| Zip Code Of The Provider | 958165234 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 131 |
| Number Of Services | 8706 |
| Number Of Medicare Beneficiaries | 1565 |
| Total Submitted Charge Amount | 1390280 |
| Total Medicare Allowed Amount | 284251.96 |
| Total Medicare Payment Amount | 224381.35 |
| Total Medicare Standardized Payment Amount | 210958.09 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 6437 |
| Number Of Medicare Beneficiaries With Drug Services | 149 |
| Total Drug Submitted ChargeAmount | 16641 |
| Total Drug Medicare AllowedAmount | 2629.89 |
| Total Drug Medicare PaymentAmount | 2047.77 |
| Total Drug Medicare Standardized Payment Amount | 2047.77 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 124 |
| Number Of Medical Services | 2269 |
| Number Of Medicare Beneficiaries With Medical Services | 1565 |
| Total Medical Submitted Charge Amount | 1373639 |
| Total Medical Medicare Allowed Amount | 281622.07 |
| Total Medical Medicare Payment Amount | 222333.58 |
| Total Medical Medicare Standardized Payment Amount | 208910.32 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 169 |
| Number Of Beneficiaries Age 65 to 74 | 798 |
| Number Of Beneficiaries Age 75 to 84 | 445 |
| Number Of Beneficiaries Age Greater 84 | 153 |
| Number Of Female Beneficiaries | 1051 |
| Number Of Male Beneficiaries | 514 |
| Number Of Non Hispanic White Beneficiaries | 1301 |
| Number Of Black or African American Beneficiaries | 57 |
| Number Of AsianPacific Islander Beneficiaries | 89 |
| Number Of Hispanic Beneficiaries | 74 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1319 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 246 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0383 |