| National Provider Identifier [NPI]: | 1417937707 |
| Last Name Of The Provider | BODEN |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6879 US HIGHWAY 98 W |
| Street Address 2 Of The Provider | |
| City Of The Provider | SANTA ROSA BEACH |
| Zip Code Of The Provider | 324593257 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hospice and Palliative Care |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 17 |
| Number Of Services | 767 |
| Number Of Medicare Beneficiaries | 334 |
| Total Submitted Charge Amount | 169725 |
| Total Medicare Allowed Amount | 86830.52 |
| Total Medicare Payment Amount | 67654.35 |
| Total Medicare Standardized Payment Amount | 67032.8 |
| 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 | 17 |
| Number Of Medical Services | 767 |
| Number Of Medicare Beneficiaries With Medical Services | 334 |
| Total Medical Submitted Charge Amount | 169725 |
| Total Medical Medicare Allowed Amount | 86830.52 |
| Total Medical Medicare Payment Amount | 67654.35 |
| Total Medical Medicare Standardized Payment Amount | 67032.8 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 58 |
| Number Of Beneficiaries Age 65 to 74 | 81 |
| Number Of Beneficiaries Age 75 to 84 | 101 |
| Number Of Beneficiaries Age Greater 84 | 94 |
| Number Of Female Beneficiaries | 178 |
| Number Of Male Beneficiaries | 156 |
| Number Of Non Hispanic White Beneficiaries | 266 |
| Number Of Black or African American Beneficiaries | 56 |
| 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 | 199 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 135 |
| Percent Of With Atrial Fibrillation | 31 |
| Percent Of With Alzheimers Disease or Dementia | 44 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 58 |
| Percent Of With Chronic Kidney Disease | 61 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 43 |
| Percent Of With Depression | 47 |
| Percent Of With Diabetes | 50 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 65 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 15 |
| Percent Of With Stroke | 21 |
| Average HCC Risk Score Of Beneficiaries | 2.1574 |