| National Provider Identifier [NPI]: | 1548217466 |
| Last Name Of The Provider | BOLL |
| First Name Of The Provider | ROBERT |
| Middle Initial Of The Provider | F |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 15300 WEST AVENUE |
| Street Address 2 Of The Provider | SUITE 220 S. |
| City Of The Provider | ORLAND PARK |
| Zip Code Of The Provider | 604624600 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 55 |
| Number Of Services | 3909 |
| Number Of Medicare Beneficiaries | 818 |
| Total Submitted Charge Amount | 283529 |
| Total Medicare Allowed Amount | 176756.62 |
| Total Medicare Payment Amount | 119935.84 |
| Total Medicare Standardized Payment Amount | 115748.84 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 15 |
| Number Of Drug Services | 472 |
| Number Of Medicare Beneficiaries With Drug Services | 230 |
| Total Drug Submitted ChargeAmount | 21390 |
| Total Drug Medicare AllowedAmount | 10978.7 |
| Total Drug Medicare PaymentAmount | 10447.08 |
| Total Drug Medicare Standardized Payment Amount | 10447.08 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 40 |
| Number Of Medical Services | 3437 |
| Number Of Medicare Beneficiaries With Medical Services | 817 |
| Total Medical Submitted Charge Amount | 262139 |
| Total Medical Medicare Allowed Amount | 165777.92 |
| Total Medical Medicare Payment Amount | 109488.76 |
| Total Medical Medicare Standardized Payment Amount | 105301.76 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 75 |
| Number Of Beneficiaries Age 65 to 74 | 390 |
| Number Of Beneficiaries Age 75 to 84 | 233 |
| Number Of Beneficiaries Age Greater 84 | 120 |
| Number Of Female Beneficiaries | 460 |
| Number Of Male Beneficiaries | 358 |
| Number Of Non Hispanic White Beneficiaries | 795 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 779 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 39 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.9861 |