| National Provider Identifier [NPI]: | 1588635965 |
| Last Name Of The Provider | ARCHER |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 620 NORTHWESTERN DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | STORM LAKE |
| Zip Code Of The Provider | 505882935 |
| State Code Of The Provider | IA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 122 |
| Number Of Services | 6987 |
| Number Of Medicare Beneficiaries | 662 |
| Total Submitted Charge Amount | 411517.18 |
| Total Medicare Allowed Amount | 253352.57 |
| Total Medicare Payment Amount | 189787.57 |
| Total Medicare Standardized Payment Amount | 202963.78 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 12 |
| Number Of Drug Services | 168 |
| Number Of Medicare Beneficiaries With Drug Services | 94 |
| Total Drug Submitted ChargeAmount | 2887 |
| Total Drug Medicare AllowedAmount | 2470.1 |
| Total Drug Medicare PaymentAmount | 2367.69 |
| Total Drug Medicare Standardized Payment Amount | 2367.69 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 110 |
| Number Of Medical Services | 6819 |
| Number Of Medicare Beneficiaries With Medical Services | 662 |
| Total Medical Submitted Charge Amount | 408630.18 |
| Total Medical Medicare Allowed Amount | 250882.47 |
| Total Medical Medicare Payment Amount | 187419.88 |
| Total Medical Medicare Standardized Payment Amount | 200596.09 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 93 |
| Number Of Beneficiaries Age 65 to 74 | 217 |
| Number Of Beneficiaries Age 75 to 84 | 195 |
| Number Of Beneficiaries Age Greater 84 | 157 |
| Number Of Female Beneficiaries | 386 |
| Number Of Male Beneficiaries | 276 |
| Number Of Non Hispanic White Beneficiaries | 594 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 18 |
| Number Of Hispanic Beneficiaries | 39 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 453 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 209 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 28 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 13 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.2071 |