| National Provider Identifier [NPI]: | 1053369355 |
| Last Name Of The Provider | BOYANTON |
| First Name Of The Provider | AMANDA |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | N.P |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 104 W RAILROAD AVE S |
| Street Address 2 Of The Provider | |
| City Of The Provider | CRYSTAL SPRINGS |
| Zip Code Of The Provider | 390592111 |
| State Code Of The Provider | MS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 38 |
| Number Of Services | 499 |
| Number Of Medicare Beneficiaries | 81 |
| Total Submitted Charge Amount | 32160.07 |
| Total Medicare Allowed Amount | 17852.95 |
| Total Medicare Payment Amount | 13510.25 |
| Total Medicare Standardized Payment Amount | 16736.8 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 159 |
| Number Of Medicare Beneficiaries With Drug Services | 38 |
| Total Drug Submitted ChargeAmount | 6555 |
| Total Drug Medicare AllowedAmount | 3020.68 |
| Total Drug Medicare PaymentAmount | 2925.18 |
| Total Drug Medicare Standardized Payment Amount | 2925.18 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 28 |
| Number Of Medical Services | 340 |
| Number Of Medicare Beneficiaries With Medical Services | 81 |
| Total Medical Submitted Charge Amount | 25605.07 |
| Total Medical Medicare Allowed Amount | 14832.27 |
| Total Medical Medicare Payment Amount | 10585.07 |
| Total Medical Medicare Standardized Payment Amount | 13811.62 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 41 |
| Number Of Beneficiaries Age 75 to 84 | 20 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 56 |
| Number Of Male Beneficiaries | 25 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 21 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8935 |