| National Provider Identifier [NPI]: | 1699770040 |
| Last Name Of The Provider | BLOOD |
| First Name Of The Provider | JEFFREY |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1103 VILLAGE SQUARE DR |
| Street Address 2 Of The Provider | STE 100 |
| City Of The Provider | PERRYSBURG |
| Zip Code Of The Provider | 435511762 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 38 |
| Number Of Services | 2407 |
| Number Of Medicare Beneficiaries | 916 |
| Total Submitted Charge Amount | 301507 |
| Total Medicare Allowed Amount | 206942.52 |
| Total Medicare Payment Amount | 159889.55 |
| Total Medicare Standardized Payment Amount | 163436.54 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 24 |
| Number Of Medicare Beneficiaries With Drug Services | 19 |
| Total Drug Submitted ChargeAmount | 2244 |
| Total Drug Medicare AllowedAmount | 1582.08 |
| Total Drug Medicare PaymentAmount | 1550.4 |
| Total Drug Medicare Standardized Payment Amount | 1550.4 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 32 |
| Number Of Medical Services | 2383 |
| Number Of Medicare Beneficiaries With Medical Services | 916 |
| Total Medical Submitted Charge Amount | 299263 |
| Total Medical Medicare Allowed Amount | 205360.44 |
| Total Medical Medicare Payment Amount | 158339.15 |
| Total Medical Medicare Standardized Payment Amount | 161886.14 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 171 |
| Number Of Beneficiaries Age 65 to 74 | 327 |
| Number Of Beneficiaries Age 75 to 84 | 247 |
| Number Of Beneficiaries Age Greater 84 | 171 |
| Number Of Female Beneficiaries | 504 |
| Number Of Male Beneficiaries | 412 |
| Number Of Non Hispanic White Beneficiaries | 765 |
| Number Of Black or African American Beneficiaries | 112 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 19 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 645 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 271 |
| Percent Of With Atrial Fibrillation | 29 |
| Percent Of With Alzheimers Disease or Dementia | 22 |
| Percent Of With Asthma | 17 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 52 |
| Percent Of With Chronic Kidney Disease | 55 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 43 |
| Percent Of With Depression | 43 |
| Percent Of With Diabetes | 50 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 62 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 57 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 12 |
| Percent Of With Stroke | 16 |
| Average HCC Risk Score Of Beneficiaries | 2.3133 |