| National Provider Identifier [NPI]: | 1205832425 |
| Last Name Of The Provider | BOOTHE |
| First Name Of The Provider | WILLIAM |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4020 21ST ST |
| Street Address 2 Of The Provider | STE 3 |
| City Of The Provider | LUBBOCK |
| Zip Code Of The Provider | 794101126 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 12 |
| Number Of Services | 2592 |
| Number Of Medicare Beneficiaries | 638 |
| Total Submitted Charge Amount | 575665 |
| Total Medicare Allowed Amount | 255881.77 |
| Total Medicare Payment Amount | 180211.36 |
| Total Medicare Standardized Payment Amount | 194085.03 |
| 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 | 12 |
| Number Of Medical Services | 2592 |
| Number Of Medicare Beneficiaries With Medical Services | 638 |
| Total Medical Submitted Charge Amount | 575665 |
| Total Medical Medicare Allowed Amount | 255881.77 |
| Total Medical Medicare Payment Amount | 180211.36 |
| Total Medical Medicare Standardized Payment Amount | 194085.03 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 62 |
| Number Of Beneficiaries Age 65 to 74 | 264 |
| Number Of Beneficiaries Age 75 to 84 | 215 |
| Number Of Beneficiaries Age Greater 84 | 97 |
| Number Of Female Beneficiaries | 406 |
| Number Of Male Beneficiaries | 232 |
| Number Of Non Hispanic White Beneficiaries | 484 |
| Number Of Black or African American Beneficiaries | 44 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 98 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 534 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 104 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0788 |