| National Provider Identifier [NPI]: | 1659582369 |
| Last Name Of The Provider | BOSTICK |
| First Name Of The Provider | SUSAN |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 809 UNIVERSITY BLVD E |
| Street Address 2 Of The Provider | |
| City Of The Provider | TUSCALOOSA |
| Zip Code Of The Provider | 354012029 |
| State Code Of The Provider | AL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 22 |
| Number Of Services | 2198 |
| Number Of Medicare Beneficiaries | 749 |
| Total Submitted Charge Amount | 347351 |
| Total Medicare Allowed Amount | 165721.94 |
| Total Medicare Payment Amount | 126350.56 |
| Total Medicare Standardized Payment Amount | 134050.98 |
| 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 | 22 |
| Number Of Medical Services | 2198 |
| Number Of Medicare Beneficiaries With Medical Services | 749 |
| Total Medical Submitted Charge Amount | 347351 |
| Total Medical Medicare Allowed Amount | 165721.94 |
| Total Medical Medicare Payment Amount | 126350.56 |
| Total Medical Medicare Standardized Payment Amount | 134050.98 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 167 |
| Number Of Beneficiaries Age 65 to 74 | 287 |
| Number Of Beneficiaries Age 75 to 84 | 212 |
| Number Of Beneficiaries Age Greater 84 | 83 |
| Number Of Female Beneficiaries | 469 |
| Number Of Male Beneficiaries | 280 |
| Number Of Non Hispanic White Beneficiaries | 465 |
| Number Of Black or African American Beneficiaries | |
| 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 | 520 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 229 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 19 |
| Percent Of With Cancer | 38 |
| Percent Of With Heart Failure | 36 |
| Percent Of With Chronic Kidney Disease | 46 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 32 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 47 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 2.1894 |