| National Provider Identifier [NPI]: | 1225092554 |
| Last Name Of The Provider | BOEHM |
| First Name Of The Provider | BRADLEY |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1065 US 23 NORTH |
| Street Address 2 Of The Provider | |
| City Of The Provider | ALPENA |
| Zip Code Of The Provider | 49707 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 91 |
| Number Of Services | 9097 |
| Number Of Medicare Beneficiaries | 1468 |
| Total Submitted Charge Amount | 1038230 |
| Total Medicare Allowed Amount | 591719.47 |
| Total Medicare Payment Amount | 433854.3 |
| Total Medicare Standardized Payment Amount | 449676.38 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 2135 |
| Number Of Medicare Beneficiaries With Drug Services | 91 |
| Total Drug Submitted ChargeAmount | 175830 |
| Total Drug Medicare AllowedAmount | 106065.69 |
| Total Drug Medicare PaymentAmount | 82650.97 |
| Total Drug Medicare Standardized Payment Amount | 82650.97 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 84 |
| Number Of Medical Services | 6962 |
| Number Of Medicare Beneficiaries With Medical Services | 1468 |
| Total Medical Submitted Charge Amount | 862400 |
| Total Medical Medicare Allowed Amount | 485653.78 |
| Total Medical Medicare Payment Amount | 351203.33 |
| Total Medical Medicare Standardized Payment Amount | 367025.41 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 182 |
| Number Of Beneficiaries Age 65 to 74 | 517 |
| Number Of Beneficiaries Age 75 to 84 | 556 |
| Number Of Beneficiaries Age Greater 84 | 213 |
| Number Of Female Beneficiaries | 395 |
| Number Of Male Beneficiaries | 1073 |
| Number Of Non Hispanic White Beneficiaries | 1447 |
| 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 | 1239 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 229 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 3 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.2858 |