| National Provider Identifier [NPI]: | 1154387082 |
| Last Name Of The Provider | BOUCHE |
| First Name Of The Provider | PAUL |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 19 BRAMBLE BUSH DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | FALMOUTH |
| Zip Code Of The Provider | 025402325 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 81 |
| Number Of Services | 3010 |
| Number Of Medicare Beneficiaries | 661 |
| Total Submitted Charge Amount | 958495 |
| Total Medicare Allowed Amount | 262955.32 |
| Total Medicare Payment Amount | 195992.85 |
| Total Medicare Standardized Payment Amount | 193550.42 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 284 |
| Number Of Medicare Beneficiaries With Drug Services | 37 |
| Total Drug Submitted ChargeAmount | 156380 |
| Total Drug Medicare AllowedAmount | 51916.22 |
| Total Drug Medicare PaymentAmount | 40618.64 |
| Total Drug Medicare Standardized Payment Amount | 40618.64 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 76 |
| Number Of Medical Services | 2726 |
| Number Of Medicare Beneficiaries With Medical Services | 661 |
| Total Medical Submitted Charge Amount | 802115 |
| Total Medical Medicare Allowed Amount | 211039.1 |
| Total Medical Medicare Payment Amount | 155374.21 |
| Total Medical Medicare Standardized Payment Amount | 152931.78 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 24 |
| Number Of Beneficiaries Age 65 to 74 | 211 |
| Number Of Beneficiaries Age 75 to 84 | 267 |
| Number Of Beneficiaries Age Greater 84 | 159 |
| Number Of Female Beneficiaries | 161 |
| Number Of Male Beneficiaries | 500 |
| Number Of Non Hispanic White Beneficiaries | 625 |
| Number Of Black or African American Beneficiaries | 13 |
| 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 | 591 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 70 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 27 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.3537 |