National Provider Identifier [NPI]: |
1518917871 |
Last Name Of The Provider |
BOHL |
First Name Of The Provider |
WILLIAM |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1730 W 25TH ST |
Street Address 2 Of The Provider |
SUITE 3200 |
City Of The Provider |
CLEVELAND |
Zip Code Of The Provider |
441133108 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Orthopedic Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
91 |
Number Of Services |
803 |
Number Of Medicare Beneficiaries |
165 |
Total Submitted Charge Amount |
249625 |
Total Medicare Allowed Amount |
89649.42 |
Total Medicare Payment Amount |
67270.26 |
Total Medicare Standardized Payment Amount |
67447.53 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
118 |
Number Of Medicare Beneficiaries With Drug Services |
52 |
Total Drug Submitted ChargeAmount |
12340 |
Total Drug Medicare AllowedAmount |
4449.89 |
Total Drug Medicare PaymentAmount |
3392.47 |
Total Drug Medicare Standardized Payment Amount |
3392.47 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
87 |
Number Of Medical Services |
685 |
Number Of Medicare Beneficiaries With Medical Services |
165 |
Total Medical Submitted Charge Amount |
237285 |
Total Medical Medicare Allowed Amount |
85199.53 |
Total Medical Medicare Payment Amount |
63877.79 |
Total Medical Medicare Standardized Payment Amount |
64055.06 |
Average Age Of Beneficiaries |
63 |
Number Of Beneficiaries Age Less65 |
81 |
Number Of Beneficiaries Age 65 to 74 |
47 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
111 |
Number Of Male Beneficiaries |
54 |
Number Of Non Hispanic White Beneficiaries |
109 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
29 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
72 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
93 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
25 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
22 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
41 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
41 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
15 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.3826 |