| National Provider Identifier [NPI]: | 1962497297 |
| Last Name Of The Provider | BUSH |
| First Name Of The Provider | WILLIAM |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6601 WHITE FEATHER RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | JOSHUA TREE |
| Zip Code Of The Provider | 922526607 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pathology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 31 |
| Number Of Services | 18333 |
| Number Of Medicare Beneficiaries | 2671 |
| Total Submitted Charge Amount | 1818582.34 |
| Total Medicare Allowed Amount | 1286972.44 |
| Total Medicare Payment Amount | 1000359.3 |
| Total Medicare Standardized Payment Amount | 758997.31 |
| 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 | 31 |
| Number Of Medical Services | 18333 |
| Number Of Medicare Beneficiaries With Medical Services | 2671 |
| Total Medical Submitted Charge Amount | 1818582.34 |
| Total Medical Medicare Allowed Amount | 1286972.44 |
| Total Medical Medicare Payment Amount | 1000359.3 |
| Total Medical Medicare Standardized Payment Amount | 758997.31 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 215 |
| Number Of Beneficiaries Age 65 to 74 | 1184 |
| Number Of Beneficiaries Age 75 to 84 | 935 |
| Number Of Beneficiaries Age Greater 84 | 337 |
| Number Of Female Beneficiaries | 1329 |
| Number Of Male Beneficiaries | 1342 |
| Number Of Non Hispanic White Beneficiaries | 2429 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 36 |
| Number Of Hispanic Beneficiaries | 135 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 33 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2286 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 385 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.1849 |