| National Provider Identifier [NPI]: | 1982765152 |
| Last Name Of The Provider | BOOTH |
| First Name Of The Provider | JACK |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 930 BETHESDA DR. BLDG 4 |
| Street Address 2 Of The Provider | |
| City Of The Provider | ZANESVILLE |
| Zip Code Of The Provider | 437010815 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Otolaryngology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 67 |
| Number Of Services | 2060 |
| Number Of Medicare Beneficiaries | 623 |
| Total Submitted Charge Amount | 234017.5 |
| Total Medicare Allowed Amount | 123445.12 |
| Total Medicare Payment Amount | 89569.37 |
| Total Medicare Standardized Payment Amount | 93652.8 |
| 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 | 67 |
| Number Of Medical Services | 2060 |
| Number Of Medicare Beneficiaries With Medical Services | 623 |
| Total Medical Submitted Charge Amount | 234017.5 |
| Total Medical Medicare Allowed Amount | 123445.12 |
| Total Medical Medicare Payment Amount | 89569.37 |
| Total Medical Medicare Standardized Payment Amount | 93652.8 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 106 |
| Number Of Beneficiaries Age 65 to 74 | 221 |
| Number Of Beneficiaries Age 75 to 84 | 183 |
| Number Of Beneficiaries Age Greater 84 | 113 |
| Number Of Female Beneficiaries | 363 |
| Number Of Male Beneficiaries | 260 |
| Number Of Non Hispanic White Beneficiaries | 597 |
| Number Of Black or African American Beneficiaries | 15 |
| 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 | 474 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 149 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.2037 |