| National Provider Identifier [NPI]: | 1275521270 |
| Last Name Of The Provider | BOUCHARD |
| First Name Of The Provider | JAMES |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | DPM |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 15 HURRICANE SHOALS RD NE |
| Street Address 2 Of The Provider | SUITE A |
| City Of The Provider | LAWRENCEVILLE |
| Zip Code Of The Provider | 300464454 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 36 |
| Number Of Services | 4074 |
| Number Of Medicare Beneficiaries | 535 |
| Total Submitted Charge Amount | 504485 |
| Total Medicare Allowed Amount | 253055.19 |
| Total Medicare Payment Amount | 181241.02 |
| Total Medicare Standardized Payment Amount | 190091.82 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 637 |
| Number Of Medicare Beneficiaries With Drug Services | 137 |
| Total Drug Submitted ChargeAmount | 3190 |
| Total Drug Medicare AllowedAmount | 81.82 |
| Total Drug Medicare PaymentAmount | 62.09 |
| Total Drug Medicare Standardized Payment Amount | 62.09 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 35 |
| Number Of Medical Services | 3437 |
| Number Of Medicare Beneficiaries With Medical Services | 535 |
| Total Medical Submitted Charge Amount | 501295 |
| Total Medical Medicare Allowed Amount | 252973.37 |
| Total Medical Medicare Payment Amount | 181178.93 |
| Total Medical Medicare Standardized Payment Amount | 190029.73 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 108 |
| Number Of Beneficiaries Age 65 to 74 | 179 |
| Number Of Beneficiaries Age 75 to 84 | 146 |
| Number Of Beneficiaries Age Greater 84 | 102 |
| Number Of Female Beneficiaries | 293 |
| Number Of Male Beneficiaries | 242 |
| Number Of Non Hispanic White Beneficiaries | 310 |
| Number Of Black or African American Beneficiaries | 199 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 12 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 368 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 167 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.5244 |