| National Provider Identifier [NPI]: | 1912919630 |
| Last Name Of The Provider | ANHALT |
| First Name Of The Provider | JEFFREY |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1314 E APPLE AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | MUSKEGON |
| Zip Code Of The Provider | 494423759 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 147 |
| Number Of Services | 1703 |
| Number Of Medicare Beneficiaries | 372 |
| Total Submitted Charge Amount | 624779.78 |
| Total Medicare Allowed Amount | 187724.88 |
| Total Medicare Payment Amount | 139676.91 |
| Total Medicare Standardized Payment Amount | 146670.12 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 57 |
| Number Of Medicare Beneficiaries With Drug Services | 41 |
| Total Drug Submitted ChargeAmount | 326.22 |
| Total Drug Medicare AllowedAmount | 193.4 |
| Total Drug Medicare PaymentAmount | 149.04 |
| Total Drug Medicare Standardized Payment Amount | 149.04 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 143 |
| Number Of Medical Services | 1646 |
| Number Of Medicare Beneficiaries With Medical Services | 372 |
| Total Medical Submitted Charge Amount | 624453.56 |
| Total Medical Medicare Allowed Amount | 187531.48 |
| Total Medical Medicare Payment Amount | 139527.87 |
| Total Medical Medicare Standardized Payment Amount | 146521.08 |
| Average Age Of Beneficiaries | 65 |
| Number Of Beneficiaries Age Less65 | 143 |
| Number Of Beneficiaries Age 65 to 74 | 134 |
| Number Of Beneficiaries Age 75 to 84 | 70 |
| Number Of Beneficiaries Age Greater 84 | 25 |
| Number Of Female Beneficiaries | 252 |
| Number Of Male Beneficiaries | 120 |
| Number Of Non Hispanic White Beneficiaries | 317 |
| Number Of Black or African American Beneficiaries | 39 |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| 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 | 254 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 118 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 60 |
| Percent Of With Ischemic Heart Disease | 24 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 55 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.19 |