National Provider Identifier [NPI]: |
1346342235 |
Last Name Of The Provider |
BOSSI |
First Name Of The Provider |
THOMAS |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
DO |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
8020 DAVISON RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
DAVISON |
Zip Code Of The Provider |
484232029 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
65 |
Number Of Services |
2353 |
Number Of Medicare Beneficiaries |
380 |
Total Submitted Charge Amount |
238593.01 |
Total Medicare Allowed Amount |
155893.64 |
Total Medicare Payment Amount |
115859.81 |
Total Medicare Standardized Payment Amount |
122242.88 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
13 |
Number Of Drug Services |
333 |
Number Of Medicare Beneficiaries With Drug Services |
138 |
Total Drug Submitted ChargeAmount |
9628.01 |
Total Drug Medicare AllowedAmount |
6861.31 |
Total Drug Medicare PaymentAmount |
6170.43 |
Total Drug Medicare Standardized Payment Amount |
6170.43 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
52 |
Number Of Medical Services |
2020 |
Number Of Medicare Beneficiaries With Medical Services |
379 |
Total Medical Submitted Charge Amount |
228965 |
Total Medical Medicare Allowed Amount |
149032.33 |
Total Medical Medicare Payment Amount |
109689.38 |
Total Medical Medicare Standardized Payment Amount |
116072.45 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
58 |
Number Of Beneficiaries Age 65 to 74 |
167 |
Number Of Beneficiaries Age 75 to 84 |
98 |
Number Of Beneficiaries Age Greater 84 |
57 |
Number Of Female Beneficiaries |
197 |
Number Of Male Beneficiaries |
183 |
Number Of Non Hispanic White Beneficiaries |
368 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
0 |
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 |
342 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
38 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
24 |
Percent Of With Chronic Kidney Disease |
29 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
47 |
Percent Of With Hypertension |
54 |
Percent Of With Ischemic Heart Disease |
41 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.2144 |