| National Provider Identifier [NPI]: | 1609865021 |
| Last Name Of The Provider | BOSWELL |
| First Name Of The Provider | VINCENT |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D., P.C. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 285 BOULEVARD NE |
| Street Address 2 Of The Provider | SUITE 115 |
| City Of The Provider | ATLANTA |
| Zip Code Of The Provider | 303124205 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 61 |
| Number Of Services | 412 |
| Number Of Medicare Beneficiaries | 93 |
| Total Submitted Charge Amount | 248734 |
| Total Medicare Allowed Amount | 51087.56 |
| Total Medicare Payment Amount | 38684.81 |
| Total Medicare Standardized Payment Amount | 38833.44 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 37 |
| Number Of Medicare Beneficiaries With Drug Services | 21 |
| Total Drug Submitted ChargeAmount | 4092 |
| Total Drug Medicare AllowedAmount | 979.31 |
| Total Drug Medicare PaymentAmount | 700.37 |
| Total Drug Medicare Standardized Payment Amount | 700.37 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 59 |
| Number Of Medical Services | 375 |
| Number Of Medicare Beneficiaries With Medical Services | 93 |
| Total Medical Submitted Charge Amount | 244642 |
| Total Medical Medicare Allowed Amount | 50108.25 |
| Total Medical Medicare Payment Amount | 37984.44 |
| Total Medical Medicare Standardized Payment Amount | 38133.07 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 37 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | 28 |
| Number Of Female Beneficiaries | 71 |
| Number Of Male Beneficiaries | 22 |
| Number Of Non Hispanic White Beneficiaries | 46 |
| 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 | 16 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 73 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 22 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 60 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.338 |