| National Provider Identifier [NPI]: | 1053374165 |
| Last Name Of The Provider | BONZELAAR |
| First Name Of The Provider | WILLIAM |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 904 S WASHINGTON AVE |
| Street Address 2 Of The Provider | SUITE 210 |
| City Of The Provider | HOLLAND |
| Zip Code Of The Provider | 494237724 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 48 |
| Number Of Services | 746 |
| Number Of Medicare Beneficiaries | 201 |
| Total Submitted Charge Amount | 75620 |
| Total Medicare Allowed Amount | 47115.71 |
| Total Medicare Payment Amount | 32060.9 |
| Total Medicare Standardized Payment Amount | 34233.76 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 98 |
| Number Of Medicare Beneficiaries With Drug Services | 68 |
| Total Drug Submitted ChargeAmount | 3544 |
| Total Drug Medicare AllowedAmount | 2602.02 |
| Total Drug Medicare PaymentAmount | 2394.54 |
| Total Drug Medicare Standardized Payment Amount | 2394.54 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 41 |
| Number Of Medical Services | 648 |
| Number Of Medicare Beneficiaries With Medical Services | 201 |
| Total Medical Submitted Charge Amount | 72076 |
| Total Medical Medicare Allowed Amount | 44513.69 |
| Total Medical Medicare Payment Amount | 29666.36 |
| Total Medical Medicare Standardized Payment Amount | 31839.22 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 27 |
| Number Of Beneficiaries Age 65 to 74 | 73 |
| Number Of Beneficiaries Age 75 to 84 | 56 |
| Number Of Beneficiaries Age Greater 84 | 45 |
| Number Of Female Beneficiaries | 105 |
| Number Of Male Beneficiaries | 96 |
| Number Of Non Hispanic White Beneficiaries | 181 |
| 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 | 183 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 18 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 41 |
| Percent Of With Hypertension | 55 |
| Percent Of With Ischemic Heart Disease | 28 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 28 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9607 |