| National Provider Identifier [NPI]: | 1679511901 |
| Last Name Of The Provider | DOHSE |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 12701 W 143RD ST |
| Street Address 2 Of The Provider | SUITE 250 |
| City Of The Provider | HOMER GLEN |
| Zip Code Of The Provider | 604917715 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 35 |
| Number Of Services | 2262 |
| Number Of Medicare Beneficiaries | 502 |
| Total Submitted Charge Amount | 170402.83 |
| Total Medicare Allowed Amount | 167438.74 |
| Total Medicare Payment Amount | 116822.44 |
| Total Medicare Standardized Payment Amount | 110900.93 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 109 |
| Number Of Medicare Beneficiaries With Drug Services | 65 |
| Total Drug Submitted ChargeAmount | 1843.54 |
| Total Drug Medicare AllowedAmount | 1834.54 |
| Total Drug Medicare PaymentAmount | 1772.46 |
| Total Drug Medicare Standardized Payment Amount | 1772.46 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 31 |
| Number Of Medical Services | 2153 |
| Number Of Medicare Beneficiaries With Medical Services | 502 |
| Total Medical Submitted Charge Amount | 168559.29 |
| Total Medical Medicare Allowed Amount | 165604.2 |
| Total Medical Medicare Payment Amount | 115049.98 |
| Total Medical Medicare Standardized Payment Amount | 109128.47 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 16 |
| Number Of Beneficiaries Age 65 to 74 | 260 |
| Number Of Beneficiaries Age 75 to 84 | 154 |
| Number Of Beneficiaries Age Greater 84 | 72 |
| Number Of Female Beneficiaries | 265 |
| Number Of Male Beneficiaries | 237 |
| Number Of Non Hispanic White Beneficiaries | 486 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 491 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 11 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 10 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.0159 |