National Provider Identifier [NPI]: |
1841563749 |
Last Name Of The Provider |
BOHLE |
First Name Of The Provider |
ANNE |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
P.A. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1990 LARKIN AVE |
Street Address 2 Of The Provider |
SUITE 3 |
City Of The Provider |
ELGIN |
Zip Code Of The Provider |
601235827 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
7 |
Number Of Services |
3860 |
Number Of Medicare Beneficiaries |
1058 |
Total Submitted Charge Amount |
457468 |
Total Medicare Allowed Amount |
271012.04 |
Total Medicare Payment Amount |
208082.38 |
Total Medicare Standardized Payment Amount |
231086.22 |
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 |
7 |
Number Of Medical Services |
3860 |
Number Of Medicare Beneficiaries With Medical Services |
1058 |
Total Medical Submitted Charge Amount |
457468 |
Total Medical Medicare Allowed Amount |
271012.04 |
Total Medical Medicare Payment Amount |
208082.38 |
Total Medical Medicare Standardized Payment Amount |
231086.22 |
Average Age Of Beneficiaries |
80 |
Number Of Beneficiaries Age Less65 |
53 |
Number Of Beneficiaries Age 65 to 74 |
250 |
Number Of Beneficiaries Age 75 to 84 |
355 |
Number Of Beneficiaries Age Greater 84 |
400 |
Number Of Female Beneficiaries |
696 |
Number Of Male Beneficiaries |
362 |
Number Of Non Hispanic White Beneficiaries |
883 |
Number Of Black or African American Beneficiaries |
58 |
Number Of AsianPacific Islander Beneficiaries |
37 |
Number Of Hispanic Beneficiaries |
65 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
15 |
Number Of Beneficiaries With Medicare Only Entitlement |
689 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
369 |
Percent Of With Atrial Fibrillation |
26 |
Percent Of With Alzheimers Disease or Dementia |
51 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
48 |
Percent Of With Chronic Kidney Disease |
56 |
Percent Of With Chronic Obstructive Pulmonary Disease |
35 |
Percent Of With Depression |
49 |
Percent Of With Diabetes |
48 |
Percent Of With Hyperlipidemia |
71 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
57 |
Percent Of With Osteoporosis |
22 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
72 |
Percent Of With Schizophrenia Other PsychoticDisorders |
16 |
Percent Of With Stroke |
17 |
Average HCC Risk Score Of Beneficiaries |
2.4783 |