| National Provider Identifier [NPI]: | 1437157724 |
| Last Name Of The Provider | BOHM |
| First Name Of The Provider | GUILLERMO |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 13813 METRO PKWY |
| Street Address 2 Of The Provider | |
| City Of The Provider | FORT MYERS |
| Zip Code Of The Provider | 339124343 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Endocrinology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 55 |
| Number Of Services | 3758 |
| Number Of Medicare Beneficiaries | 816 |
| Total Submitted Charge Amount | 492144.5 |
| Total Medicare Allowed Amount | 238701.01 |
| Total Medicare Payment Amount | 171466.95 |
| Total Medicare Standardized Payment Amount | 166123.24 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 1501 |
| Number Of Medicare Beneficiaries With Drug Services | 24 |
| Total Drug Submitted ChargeAmount | 31859.5 |
| Total Drug Medicare AllowedAmount | 15710.99 |
| Total Drug Medicare PaymentAmount | 12327.51 |
| Total Drug Medicare Standardized Payment Amount | 12327.51 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 51 |
| Number Of Medical Services | 2257 |
| Number Of Medicare Beneficiaries With Medical Services | 816 |
| Total Medical Submitted Charge Amount | 460285 |
| Total Medical Medicare Allowed Amount | 222990.02 |
| Total Medical Medicare Payment Amount | 159139.44 |
| Total Medical Medicare Standardized Payment Amount | 153795.73 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 109 |
| Number Of Beneficiaries Age 65 to 74 | 379 |
| Number Of Beneficiaries Age 75 to 84 | 252 |
| Number Of Beneficiaries Age Greater 84 | 76 |
| Number Of Female Beneficiaries | 473 |
| Number Of Male Beneficiaries | 343 |
| Number Of Non Hispanic White Beneficiaries | 700 |
| Number Of Black or African American Beneficiaries | 49 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 51 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 724 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 92 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 68 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.3431 |