| National Provider Identifier [NPI]: | 1235129388 |
| Last Name Of The Provider | BOLES |
| First Name Of The Provider | MARK |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1331 NORTH ELM STREET |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | GREENSBORO |
| Zip Code Of The Provider | 274016304 |
| State Code Of The Provider | NC |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 160 |
| Number Of Services | 7767 |
| Number Of Medicare Beneficiaries | 4269 |
| Total Submitted Charge Amount | 464021.2 |
| Total Medicare Allowed Amount | 142413.97 |
| Total Medicare Payment Amount | 105363.34 |
| Total Medicare Standardized Payment Amount | 111581.77 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 2044 |
| Number Of Medicare Beneficiaries With Drug Services | 24 |
| Total Drug Submitted ChargeAmount | 1561.2 |
| Total Drug Medicare AllowedAmount | 550.84 |
| Total Drug Medicare PaymentAmount | 431.82 |
| Total Drug Medicare Standardized Payment Amount | 431.82 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 157 |
| Number Of Medical Services | 5723 |
| Number Of Medicare Beneficiaries With Medical Services | 4269 |
| Total Medical Submitted Charge Amount | 462460 |
| Total Medical Medicare Allowed Amount | 141863.13 |
| Total Medical Medicare Payment Amount | 104931.52 |
| Total Medical Medicare Standardized Payment Amount | 111149.95 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 976 |
| Number Of Beneficiaries Age 65 to 74 | 1465 |
| Number Of Beneficiaries Age 75 to 84 | 1119 |
| Number Of Beneficiaries Age Greater 84 | 709 |
| Number Of Female Beneficiaries | 2557 |
| Number Of Male Beneficiaries | 1712 |
| Number Of Non Hispanic White Beneficiaries | 3274 |
| Number Of Black or African American Beneficiaries | 891 |
| Number Of AsianPacific Islander Beneficiaries | 29 |
| Number Of Hispanic Beneficiaries | 48 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2940 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1329 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 34 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.8158 |