| National Provider Identifier [NPI]: | 1184602278 |
| Last Name Of The Provider | HAVENS |
| First Name Of The Provider | PHILIP |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1501 BRIGHT ROAD |
| Street Address 2 Of The Provider | |
| City Of The Provider | FINDLAY |
| Zip Code Of The Provider | 458400000 |
| 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 | 154 |
| Number Of Services | 4999 |
| Number Of Medicare Beneficiaries | 926 |
| Total Submitted Charge Amount | 431957.73 |
| Total Medicare Allowed Amount | 355242.35 |
| Total Medicare Payment Amount | 267202.92 |
| Total Medicare Standardized Payment Amount | 263016.08 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 965 |
| Number Of Medicare Beneficiaries With Drug Services | 118 |
| Total Drug Submitted ChargeAmount | 27382 |
| Total Drug Medicare AllowedAmount | 12772.04 |
| Total Drug Medicare PaymentAmount | 9783.02 |
| Total Drug Medicare Standardized Payment Amount | 9783.02 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 150 |
| Number Of Medical Services | 4034 |
| Number Of Medicare Beneficiaries With Medical Services | 926 |
| Total Medical Submitted Charge Amount | 404575.73 |
| Total Medical Medicare Allowed Amount | 342470.31 |
| Total Medical Medicare Payment Amount | 257419.9 |
| Total Medical Medicare Standardized Payment Amount | 253233.06 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 84 |
| Number Of Beneficiaries Age 65 to 74 | 411 |
| Number Of Beneficiaries Age 75 to 84 | 299 |
| Number Of Beneficiaries Age Greater 84 | 132 |
| Number Of Female Beneficiaries | 569 |
| Number Of Male Beneficiaries | 357 |
| Number Of Non Hispanic White Beneficiaries | 885 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 11 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 19 |
| Number Of Beneficiaries With Medicare Only Entitlement | 802 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 124 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 70 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.1405 |