| National Provider Identifier [NPI]: | 1922240282 |
| Last Name Of The Provider | RUPERT |
| First Name Of The Provider | LAURA |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | PA-C, ATC |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 300 POLARIS PKWY |
| Street Address 2 Of The Provider | SUITE 2000 |
| City Of The Provider | WESTERVILLE |
| Zip Code Of The Provider | 430827989 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 36 |
| Number Of Services | 921 |
| Number Of Medicare Beneficiaries | 154 |
| Total Submitted Charge Amount | 92626 |
| Total Medicare Allowed Amount | 24225.49 |
| Total Medicare Payment Amount | 17735.66 |
| Total Medicare Standardized Payment Amount | 20234 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 643 |
| Number Of Medicare Beneficiaries With Drug Services | 32 |
| Total Drug Submitted ChargeAmount | 16600 |
| Total Drug Medicare AllowedAmount | 7618.57 |
| Total Drug Medicare PaymentAmount | 5888.13 |
| Total Drug Medicare Standardized Payment Amount | 5888.13 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 33 |
| Number Of Medical Services | 278 |
| Number Of Medicare Beneficiaries With Medical Services | 154 |
| Total Medical Submitted Charge Amount | 76026 |
| Total Medical Medicare Allowed Amount | 16606.92 |
| Total Medical Medicare Payment Amount | 11847.53 |
| Total Medical Medicare Standardized Payment Amount | 14345.87 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 41 |
| Number Of Beneficiaries Age 65 to 74 | 67 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 98 |
| Number Of Male Beneficiaries | 56 |
| Number Of Non Hispanic White Beneficiaries | 141 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 117 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 37 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1828 |