| National Provider Identifier [NPI]: | 1407019458 |
| Last Name Of The Provider | BOGGS |
| First Name Of The Provider | JODY |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 825 FAIRFAX AVE |
| Street Address 2 Of The Provider | SUITE445 |
| City Of The Provider | NORFOLK |
| Zip Code Of The Provider | 235071914 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 34 |
| Number Of Services | 635 |
| Number Of Medicare Beneficiaries | 219 |
| Total Submitted Charge Amount | 82279 |
| Total Medicare Allowed Amount | 46118.18 |
| Total Medicare Payment Amount | 34357.59 |
| Total Medicare Standardized Payment Amount | 35212.49 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 23 |
| Number Of Medicare Beneficiaries With Drug Services | 21 |
| Total Drug Submitted ChargeAmount | 1680 |
| Total Drug Medicare AllowedAmount | 1013.44 |
| Total Drug Medicare PaymentAmount | 993.14 |
| Total Drug Medicare Standardized Payment Amount | 993.14 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 30 |
| Number Of Medical Services | 612 |
| Number Of Medicare Beneficiaries With Medical Services | 219 |
| Total Medical Submitted Charge Amount | 80599 |
| Total Medical Medicare Allowed Amount | 45104.74 |
| Total Medical Medicare Payment Amount | 33364.45 |
| Total Medical Medicare Standardized Payment Amount | 34219.35 |
| Average Age Of Beneficiaries | 65 |
| Number Of Beneficiaries Age Less65 | 89 |
| Number Of Beneficiaries Age 65 to 74 | 63 |
| Number Of Beneficiaries Age 75 to 84 | 48 |
| Number Of Beneficiaries Age Greater 84 | 19 |
| Number Of Female Beneficiaries | 126 |
| Number Of Male Beneficiaries | 93 |
| Number Of Non Hispanic White Beneficiaries | 86 |
| Number Of Black or African American Beneficiaries | 122 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 115 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 104 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 44 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 51 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 16 |
| Average HCC Risk Score Of Beneficiaries | 2.345 |