| National Provider Identifier [NPI]: | 1871536243 |
| Last Name Of The Provider | COLE |
| First Name Of The Provider | RYAN |
| Middle Initial Of The Provider | N |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7988 W. MARIGOLD ST. |
| Street Address 2 Of The Provider | STE. 150 |
| City Of The Provider | BOISE |
| Zip Code Of The Provider | 83714 |
| State Code Of The Provider | ID |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pathology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 12 |
| Number Of Services | 10427 |
| Number Of Medicare Beneficiaries | 4604 |
| Total Submitted Charge Amount | 749249.4 |
| Total Medicare Allowed Amount | 604541.56 |
| Total Medicare Payment Amount | 452418.36 |
| Total Medicare Standardized Payment Amount | 373260.96 |
| 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 | 12 |
| Number Of Medical Services | 10427 |
| Number Of Medicare Beneficiaries With Medical Services | 4604 |
| Total Medical Submitted Charge Amount | 749249.4 |
| Total Medical Medicare Allowed Amount | 604541.56 |
| Total Medical Medicare Payment Amount | 452418.36 |
| Total Medical Medicare Standardized Payment Amount | 373260.96 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 306 |
| Number Of Beneficiaries Age 65 to 74 | 1926 |
| Number Of Beneficiaries Age 75 to 84 | 1641 |
| Number Of Beneficiaries Age Greater 84 | 731 |
| Number Of Female Beneficiaries | 2192 |
| Number Of Male Beneficiaries | 2412 |
| Number Of Non Hispanic White Beneficiaries | 4415 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 71 |
| Number Of American Indian Alaska Native Beneficiaries | 33 |
| Number Of Beneficiaries With Race Not Else where Classified | 58 |
| Number Of Beneficiaries With Medicare Only Entitlement | 4218 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 386 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 41 |
| Percent Of With Hypertension | 55 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.9852 |