| National Provider Identifier [NPI]: | 1548353584 |
| Last Name Of The Provider | BUCHOLZ |
| First Name Of The Provider | JEFFREY |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3811 E BELL RD |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | PHOENIX |
| Zip Code Of The Provider | 850322138 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Interventional Pain Management |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 47 |
| Number Of Services | 9305 |
| Number Of Medicare Beneficiaries | 538 |
| Total Submitted Charge Amount | 1429873 |
| Total Medicare Allowed Amount | 524586.71 |
| Total Medicare Payment Amount | 391011.49 |
| Total Medicare Standardized Payment Amount | 355448.39 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 5680 |
| Number Of Medicare Beneficiaries With Drug Services | 320 |
| Total Drug Submitted ChargeAmount | 65427 |
| Total Drug Medicare AllowedAmount | 4746.2 |
| Total Drug Medicare PaymentAmount | 3654.14 |
| Total Drug Medicare Standardized Payment Amount | 3654.14 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 36 |
| Number Of Medical Services | 3625 |
| Number Of Medicare Beneficiaries With Medical Services | 538 |
| Total Medical Submitted Charge Amount | 1364446 |
| Total Medical Medicare Allowed Amount | 519840.51 |
| Total Medical Medicare Payment Amount | 387357.35 |
| Total Medical Medicare Standardized Payment Amount | 351794.25 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 185 |
| Number Of Beneficiaries Age 65 to 74 | 208 |
| Number Of Beneficiaries Age 75 to 84 | 111 |
| Number Of Beneficiaries Age Greater 84 | 34 |
| Number Of Female Beneficiaries | 338 |
| Number Of Male Beneficiaries | 200 |
| Number Of Non Hispanic White Beneficiaries | 469 |
| Number Of Black or African American Beneficiaries | 28 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 25 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 424 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 114 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.4027 |