| National Provider Identifier [NPI]: | 1871797472 |
| Last Name Of The Provider | BOATSMAN |
| First Name Of The Provider | JUSTIN |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 8401 DATAPOINT DR STE 600 |
| Street Address 2 Of The Provider | |
| City Of The Provider | SAN ANTONIO |
| Zip Code Of The Provider | 782295907 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 206 |
| Number Of Services | 32984 |
| Number Of Medicare Beneficiaries | 6902 |
| Total Submitted Charge Amount | 2389346.5 |
| Total Medicare Allowed Amount | 792310.59 |
| Total Medicare Payment Amount | 670520.34 |
| Total Medicare Standardized Payment Amount | 722165.8 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 21427 |
| Number Of Medicare Beneficiaries With Drug Services | 263 |
| Total Drug Submitted ChargeAmount | 15878.5 |
| Total Drug Medicare AllowedAmount | 6558.92 |
| Total Drug Medicare PaymentAmount | 5072.33 |
| Total Drug Medicare Standardized Payment Amount | 5072.33 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 203 |
| Number Of Medical Services | 11557 |
| Number Of Medicare Beneficiaries With Medical Services | 6901 |
| Total Medical Submitted Charge Amount | 2373468 |
| Total Medical Medicare Allowed Amount | 785751.67 |
| Total Medical Medicare Payment Amount | 665448.01 |
| Total Medical Medicare Standardized Payment Amount | 717093.47 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 836 |
| Number Of Beneficiaries Age 65 to 74 | 3188 |
| Number Of Beneficiaries Age 75 to 84 | 2015 |
| Number Of Beneficiaries Age Greater 84 | 863 |
| Number Of Female Beneficiaries | 5132 |
| Number Of Male Beneficiaries | 1770 |
| Number Of Non Hispanic White Beneficiaries | 4649 |
| Number Of Black or African American Beneficiaries | 300 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 1807 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 74 |
| Number Of Beneficiaries With Medicare Only Entitlement | 5779 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1123 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.5594 |