| National Provider Identifier [NPI]: | 1043512742 |
| Last Name Of The Provider | BORES |
| First Name Of The Provider | NICOLE |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1301 PIERCE ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | SAN FRANCISCO |
| Zip Code Of The Provider | 941154005 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 15 |
| Number Of Services | 428 |
| Number Of Medicare Beneficiaries | 130 |
| Total Submitted Charge Amount | 125793 |
| Total Medicare Allowed Amount | 30049.9 |
| Total Medicare Payment Amount | 20827.65 |
| Total Medicare Standardized Payment Amount | 17992.11 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 31 |
| Number Of Medicare Beneficiaries With Drug Services | 25 |
| Total Drug Submitted ChargeAmount | 1446 |
| Total Drug Medicare AllowedAmount | 783.86 |
| Total Drug Medicare PaymentAmount | 768.21 |
| Total Drug Medicare Standardized Payment Amount | 768.21 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 12 |
| Number Of Medical Services | 397 |
| Number Of Medicare Beneficiaries With Medical Services | 130 |
| Total Medical Submitted Charge Amount | 124347 |
| Total Medical Medicare Allowed Amount | 29266.04 |
| Total Medical Medicare Payment Amount | 20059.44 |
| Total Medical Medicare Standardized Payment Amount | 17223.9 |
| Average Age Of Beneficiaries | 64 |
| Number Of Beneficiaries Age Less65 | 57 |
| Number Of Beneficiaries Age 65 to 74 | 53 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 69 |
| Number Of Male Beneficiaries | 61 |
| Number Of Non Hispanic White Beneficiaries | 34 |
| Number Of Black or African American Beneficiaries | 57 |
| Number Of AsianPacific Islander Beneficiaries | 19 |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 44 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 25 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.3589 |