| National Provider Identifier [NPI]: | 1063432953 |
| Last Name Of The Provider | RALSTON |
| First Name Of The Provider | DEBORAH |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3916 N INTERTECH COURT |
| Street Address 2 Of The Provider | |
| City Of The Provider | APPLETON |
| Zip Code Of The Provider | 54913 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 111 |
| Number Of Services | 1852 |
| Number Of Medicare Beneficiaries | 188 |
| Total Submitted Charge Amount | 203769 |
| Total Medicare Allowed Amount | 51501.79 |
| Total Medicare Payment Amount | 39625.74 |
| Total Medicare Standardized Payment Amount | 41484.95 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 284 |
| Number Of Medicare Beneficiaries With Drug Services | 39 |
| Total Drug Submitted ChargeAmount | 2722 |
| Total Drug Medicare AllowedAmount | 1531.13 |
| Total Drug Medicare PaymentAmount | 1487.39 |
| Total Drug Medicare Standardized Payment Amount | 1487.39 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 105 |
| Number Of Medical Services | 1568 |
| Number Of Medicare Beneficiaries With Medical Services | 188 |
| Total Medical Submitted Charge Amount | 201047 |
| Total Medical Medicare Allowed Amount | 49970.66 |
| Total Medical Medicare Payment Amount | 38138.35 |
| Total Medical Medicare Standardized Payment Amount | 39997.56 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 31 |
| Number Of Beneficiaries Age 65 to 74 | 87 |
| Number Of Beneficiaries Age 75 to 84 | 51 |
| Number Of Beneficiaries Age Greater 84 | 19 |
| Number Of Female Beneficiaries | 156 |
| Number Of Male Beneficiaries | 32 |
| 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 | 158 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 30 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 6 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 6 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 18 |
| Percent Of With Hyperlipidemia | 36 |
| Percent Of With Hypertension | 47 |
| Percent Of With Ischemic Heart Disease | 18 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 30 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9751 |