| National Provider Identifier [NPI]: | 1457351355 |
| Last Name Of The Provider | MOLINE |
| First Name Of The Provider | WENDE |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | APRN-BC |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 9200 W LOOMIS RD |
| Street Address 2 Of The Provider | SUITE 101 |
| City Of The Provider | FRANKLIN |
| Zip Code Of The Provider | 531328887 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 24 |
| Number Of Services | 566 |
| Number Of Medicare Beneficiaries | 279 |
| Total Submitted Charge Amount | 94490.22 |
| Total Medicare Allowed Amount | 27090.61 |
| Total Medicare Payment Amount | 19404.47 |
| Total Medicare Standardized Payment Amount | 24048.48 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 26 |
| Number Of Medicare Beneficiaries With Drug Services | 24 |
| Total Drug Submitted ChargeAmount | 981.22 |
| Total Drug Medicare AllowedAmount | 543.18 |
| Total Drug Medicare PaymentAmount | 529.68 |
| Total Drug Medicare Standardized Payment Amount | 529.68 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 19 |
| Number Of Medical Services | 540 |
| Number Of Medicare Beneficiaries With Medical Services | 279 |
| Total Medical Submitted Charge Amount | 93509 |
| Total Medical Medicare Allowed Amount | 26547.43 |
| Total Medical Medicare Payment Amount | 18874.79 |
| Total Medical Medicare Standardized Payment Amount | 23518.8 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 20 |
| Number Of Beneficiaries Age 65 to 74 | 105 |
| Number Of Beneficiaries Age 75 to 84 | 117 |
| Number Of Beneficiaries Age Greater 84 | 37 |
| Number Of Female Beneficiaries | 156 |
| Number Of Male Beneficiaries | 123 |
| Number Of Non Hispanic White Beneficiaries | 266 |
| 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 | 258 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 21 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.197 |