| National Provider Identifier [NPI]: | 1225061732 |
| Last Name Of The Provider | BOK |
| First Name Of The Provider | EDWARD |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 901 MACARTHUR BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | MUNSTER |
| Zip Code Of The Provider | 463212901 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 117 |
| Number Of Services | 9138 |
| Number Of Medicare Beneficiaries | 4150 |
| Total Submitted Charge Amount | 807142 |
| Total Medicare Allowed Amount | 201252.67 |
| Total Medicare Payment Amount | 150957.71 |
| Total Medicare Standardized Payment Amount | 146257.46 |
| 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 | 117 |
| Number Of Medical Services | 9138 |
| Number Of Medicare Beneficiaries With Medical Services | 4150 |
| Total Medical Submitted Charge Amount | 807142 |
| Total Medical Medicare Allowed Amount | 201252.67 |
| Total Medical Medicare Payment Amount | 150957.71 |
| Total Medical Medicare Standardized Payment Amount | 146257.46 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 821 |
| Number Of Beneficiaries Age 65 to 74 | 1199 |
| Number Of Beneficiaries Age 75 to 84 | 1237 |
| Number Of Beneficiaries Age Greater 84 | 893 |
| Number Of Female Beneficiaries | 2333 |
| Number Of Male Beneficiaries | 1817 |
| Number Of Non Hispanic White Beneficiaries | 2905 |
| Number Of Black or African American Beneficiaries | 680 |
| Number Of AsianPacific Islander Beneficiaries | 27 |
| Number Of Hispanic Beneficiaries | 512 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 3022 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1128 |
| Percent Of With Atrial Fibrillation | 26 |
| Percent Of With Alzheimers Disease or Dementia | 27 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 56 |
| Percent Of With Chronic Kidney Disease | 53 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 45 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 50 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 68 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 13 |
| Percent Of With Stroke | 19 |
| Average HCC Risk Score Of Beneficiaries | 2.3407 |