| National Provider Identifier [NPI]: | 1235134008 |
| Last Name Of The Provider | BORISOV |
| First Name Of The Provider | IGOR |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4500 E 9TH AVE |
| Street Address 2 Of The Provider | STE 140 |
| City Of The Provider | DENVER |
| Zip Code Of The Provider | 802203920 |
| State Code Of The Provider | CO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 64 |
| Number Of Services | 3870 |
| Number Of Medicare Beneficiaries | 244 |
| Total Submitted Charge Amount | 302293.79 |
| Total Medicare Allowed Amount | 215612.37 |
| Total Medicare Payment Amount | 162491.89 |
| Total Medicare Standardized Payment Amount | 161308.89 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 154 |
| Number Of Medicare Beneficiaries With Drug Services | 86 |
| Total Drug Submitted ChargeAmount | 3683 |
| Total Drug Medicare AllowedAmount | 2135.15 |
| Total Drug Medicare PaymentAmount | 2080.81 |
| Total Drug Medicare Standardized Payment Amount | 2080.81 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 59 |
| Number Of Medical Services | 3716 |
| Number Of Medicare Beneficiaries With Medical Services | 244 |
| Total Medical Submitted Charge Amount | 298610.79 |
| Total Medical Medicare Allowed Amount | 213477.22 |
| Total Medical Medicare Payment Amount | 160411.08 |
| Total Medical Medicare Standardized Payment Amount | 159228.08 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 16 |
| Number Of Beneficiaries Age 65 to 74 | 62 |
| Number Of Beneficiaries Age 75 to 84 | 104 |
| Number Of Beneficiaries Age Greater 84 | 62 |
| Number Of Female Beneficiaries | 158 |
| Number Of Male Beneficiaries | 86 |
| Number Of Non Hispanic White Beneficiaries | 202 |
| 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 | 22 |
| Number Of Beneficiaries With Medicare Only Entitlement | 35 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 209 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 23 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 34 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 40 |
| Percent Of With Diabetes | 49 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 60 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.6553 |