| National Provider Identifier [NPI]: | 1740362573 |
| Last Name Of The Provider | MOSLEY |
| First Name Of The Provider | G |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1700 W PARADISE DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | WEST BEND |
| Zip Code Of The Provider | 530959795 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 98 |
| Number Of Services | 2963 |
| Number Of Medicare Beneficiaries | 771 |
| Total Submitted Charge Amount | 546768.35 |
| Total Medicare Allowed Amount | 158646.88 |
| Total Medicare Payment Amount | 113653.88 |
| Total Medicare Standardized Payment Amount | 119752.3 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 12 |
| Number Of Drug Services | 157 |
| Number Of Medicare Beneficiaries With Drug Services | 117 |
| Total Drug Submitted ChargeAmount | 6427.84 |
| Total Drug Medicare AllowedAmount | 4363.19 |
| Total Drug Medicare PaymentAmount | 4208.07 |
| Total Drug Medicare Standardized Payment Amount | 4208.07 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 86 |
| Number Of Medical Services | 2806 |
| Number Of Medicare Beneficiaries With Medical Services | 771 |
| Total Medical Submitted Charge Amount | 540340.51 |
| Total Medical Medicare Allowed Amount | 154283.69 |
| Total Medical Medicare Payment Amount | 109445.81 |
| Total Medical Medicare Standardized Payment Amount | 115544.23 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 45 |
| Number Of Beneficiaries Age 65 to 74 | 279 |
| Number Of Beneficiaries Age 75 to 84 | 275 |
| Number Of Beneficiaries Age Greater 84 | 172 |
| Number Of Female Beneficiaries | 455 |
| Number Of Male Beneficiaries | 316 |
| Number Of Non Hispanic White Beneficiaries | 758 |
| Number Of Black or African American Beneficiaries | 0 |
| 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 | 705 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 66 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.3226 |