| National Provider Identifier [NPI]: | 1235143512 |
| Last Name Of The Provider | BOAKE |
| First Name Of The Provider | GREGORY |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | D.P.M. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3520 GUION RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | INDIANAPOLIS |
| Zip Code Of The Provider | 462221692 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 77 |
| Number Of Services | 2591 |
| Number Of Medicare Beneficiaries | 485 |
| Total Submitted Charge Amount | 319496.94 |
| Total Medicare Allowed Amount | 169044 |
| Total Medicare Payment Amount | 126257.17 |
| Total Medicare Standardized Payment Amount | 133591.48 |
| Drug Suppress Indicator | * |
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| Medical SuppressIndicator | # |
| Number Of HCPCS Associated With MedicalServices | |
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| Number Of Medicare Beneficiaries With Medical Services | |
| Total Medical Submitted Charge Amount | |
| Total Medical Medicare Allowed Amount | |
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| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 143 |
| Number Of Beneficiaries Age 65 to 74 | 150 |
| Number Of Beneficiaries Age 75 to 84 | 128 |
| Number Of Beneficiaries Age Greater 84 | 64 |
| Number Of Female Beneficiaries | 243 |
| Number Of Male Beneficiaries | 242 |
| Number Of Non Hispanic White Beneficiaries | 335 |
| Number Of Black or African American Beneficiaries | 139 |
| 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 | 314 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 171 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 40 |
| Percent Of With Chronic Kidney Disease | 48 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 66 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 2.5846 |