| National Provider Identifier [NPI]: | 1346213519 |
| Last Name Of The Provider | BOEHM |
| First Name Of The Provider | WILLIAM |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | N14W23900 STONE RIDGE DR |
| Street Address 2 Of The Provider | PROHEALTH CARE MEDICAL ASSOCIATES INC. |
| City Of The Provider | WAUKESHA |
| Zip Code Of The Provider | 531881135 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 30 |
| Number Of Services | 1887 |
| Number Of Medicare Beneficiaries | 400 |
| Total Submitted Charge Amount | 183910 |
| Total Medicare Allowed Amount | 76703.74 |
| Total Medicare Payment Amount | 54953.37 |
| Total Medicare Standardized Payment Amount | 57338 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 213 |
| Number Of Medicare Beneficiaries With Drug Services | 151 |
| Total Drug Submitted ChargeAmount | 6770 |
| Total Drug Medicare AllowedAmount | 5357.27 |
| Total Drug Medicare PaymentAmount | 5233.77 |
| Total Drug Medicare Standardized Payment Amount | 5233.77 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 23 |
| Number Of Medical Services | 1674 |
| Number Of Medicare Beneficiaries With Medical Services | 399 |
| Total Medical Submitted Charge Amount | 177140 |
| Total Medical Medicare Allowed Amount | 71346.47 |
| Total Medical Medicare Payment Amount | 49719.6 |
| Total Medical Medicare Standardized Payment Amount | 52104.23 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 39 |
| Number Of Beneficiaries Age 65 to 74 | 206 |
| Number Of Beneficiaries Age 75 to 84 | 110 |
| Number Of Beneficiaries Age Greater 84 | 45 |
| Number Of Female Beneficiaries | 170 |
| Number Of Male Beneficiaries | 230 |
| Number Of Non Hispanic White Beneficiaries | 389 |
| 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 | 369 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 31 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 59 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 27 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9677 |