| National Provider Identifier [NPI]: | 1184650905 |
| Last Name Of The Provider | MOELLER |
| First Name Of The Provider | LAURA |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1605 SE DELAWARE AVE |
| Street Address 2 Of The Provider | SUITE F |
| City Of The Provider | ANKENY |
| Zip Code Of The Provider | 500214595 |
| 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 | 42 |
| Number Of Services | 1012 |
| Number Of Medicare Beneficiaries | 83 |
| Total Submitted Charge Amount | 71253 |
| Total Medicare Allowed Amount | 39374.94 |
| Total Medicare Payment Amount | 30964.24 |
| Total Medicare Standardized Payment Amount | 33439.92 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 73 |
| Number Of Medicare Beneficiaries With Drug Services | 49 |
| Total Drug Submitted ChargeAmount | 5562 |
| Total Drug Medicare AllowedAmount | 4286.48 |
| Total Drug Medicare PaymentAmount | 4198.08 |
| Total Drug Medicare Standardized Payment Amount | 4198.08 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 36 |
| Number Of Medical Services | 939 |
| Number Of Medicare Beneficiaries With Medical Services | 83 |
| Total Medical Submitted Charge Amount | 65691 |
| Total Medical Medicare Allowed Amount | 35088.46 |
| Total Medical Medicare Payment Amount | 26766.16 |
| Total Medical Medicare Standardized Payment Amount | 29241.84 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 50 |
| Number Of Beneficiaries Age 75 to 84 | 21 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 66 |
| Number Of Male Beneficiaries | 17 |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 20 |
| Percent Of With Hyperlipidemia | 73 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 23 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 30 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8202 |