National Provider Identifier [NPI]: |
1972706968 |
Last Name Of The Provider |
BOEHM |
First Name Of The Provider |
JASON |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1235 E CHEROKEE ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
SPRINGFIELD |
Zip Code Of The Provider |
658042203 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
86 |
Number Of Services |
586 |
Number Of Medicare Beneficiaries |
470 |
Total Submitted Charge Amount |
405246 |
Total Medicare Allowed Amount |
80128.4 |
Total Medicare Payment Amount |
62544.92 |
Total Medicare Standardized Payment Amount |
64161.27 |
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 |
86 |
Number Of Medical Services |
586 |
Number Of Medicare Beneficiaries With Medical Services |
470 |
Total Medical Submitted Charge Amount |
405246 |
Total Medical Medicare Allowed Amount |
80128.4 |
Total Medical Medicare Payment Amount |
62544.92 |
Total Medical Medicare Standardized Payment Amount |
64161.27 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
99 |
Number Of Beneficiaries Age 65 to 74 |
219 |
Number Of Beneficiaries Age 75 to 84 |
107 |
Number Of Beneficiaries Age Greater 84 |
45 |
Number Of Female Beneficiaries |
249 |
Number Of Male Beneficiaries |
221 |
Number Of Non Hispanic White Beneficiaries |
455 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
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 |
371 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
99 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
20 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
68 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
42 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
56 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.4692 |