| National Provider Identifier [NPI]: | 1972566024 |
| Last Name Of The Provider | BOESCH |
| First Name Of The Provider | JEFFREY |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 222 S WOODS MILL RD |
| Street Address 2 Of The Provider | SUITE 630 |
| City Of The Provider | CHESTERFIELD |
| Zip Code Of The Provider | 630173625 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 53 |
| Number Of Services | 3585 |
| Number Of Medicare Beneficiaries | 924 |
| Total Submitted Charge Amount | 469260 |
| Total Medicare Allowed Amount | 237536.37 |
| Total Medicare Payment Amount | 168626.12 |
| Total Medicare Standardized Payment Amount | 172891.94 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 315 |
| Number Of Medicare Beneficiaries With Drug Services | 255 |
| Total Drug Submitted ChargeAmount | 15107 |
| Total Drug Medicare AllowedAmount | 7878.31 |
| Total Drug Medicare PaymentAmount | 7640.78 |
| Total Drug Medicare Standardized Payment Amount | 7640.78 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 43 |
| Number Of Medical Services | 3270 |
| Number Of Medicare Beneficiaries With Medical Services | 924 |
| Total Medical Submitted Charge Amount | 454153 |
| Total Medical Medicare Allowed Amount | 229658.06 |
| Total Medical Medicare Payment Amount | 160985.34 |
| Total Medical Medicare Standardized Payment Amount | 165251.16 |
| Average Age Of Beneficiaries | 79 |
| Number Of Beneficiaries Age Less65 | 25 |
| Number Of Beneficiaries Age 65 to 74 | 295 |
| Number Of Beneficiaries Age 75 to 84 | 318 |
| Number Of Beneficiaries Age Greater 84 | 286 |
| Number Of Female Beneficiaries | 515 |
| Number Of Male Beneficiaries | 409 |
| Number Of Non Hispanic White Beneficiaries | 854 |
| Number Of Black or African American Beneficiaries | 36 |
| Number Of AsianPacific Islander Beneficiaries | 13 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 871 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 53 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 24 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.2916 |