| National Provider Identifier [NPI]: | 1366494270 |
| Last Name Of The Provider | BOLMER |
| First Name Of The Provider | AMY |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 510 ASHMUN ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | SAULT SAINTE MARIE |
| Zip Code Of The Provider | 497831964 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 84 |
| Number Of Services | 8825 |
| Number Of Medicare Beneficiaries | 115 |
| Total Submitted Charge Amount | 291072.97 |
| Total Medicare Allowed Amount | 148040.02 |
| Total Medicare Payment Amount | 112822.36 |
| Total Medicare Standardized Payment Amount | 113139.56 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 52 |
| Number Of Drug Services | 8580 |
| Number Of Medicare Beneficiaries With Drug Services | 66 |
| Total Drug Submitted ChargeAmount | 261892.01 |
| Total Drug Medicare AllowedAmount | 132256.6 |
| Total Drug Medicare PaymentAmount | 103230.91 |
| Total Drug Medicare Standardized Payment Amount | 103230.91 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 32 |
| Number Of Medical Services | 245 |
| Number Of Medicare Beneficiaries With Medical Services | 115 |
| Total Medical Submitted Charge Amount | 29180.96 |
| Total Medical Medicare Allowed Amount | 15783.42 |
| Total Medical Medicare Payment Amount | 9591.45 |
| Total Medical Medicare Standardized Payment Amount | 9908.65 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 58 |
| Number Of Beneficiaries Age 75 to 84 | 30 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 64 |
| Number Of Male Beneficiaries | 51 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 91 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 24 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | 41 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 62 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 2.357 |