| National Provider Identifier [NPI]: | 1720140536 |
| Last Name Of The Provider | MOARD |
| First Name Of The Provider | DOUGLAS |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | W5282 AMY AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | APPLETON |
| Zip Code Of The Provider | 549157233 |
| 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 | 146 |
| Number Of Services | 2650 |
| Number Of Medicare Beneficiaries | 287 |
| Total Submitted Charge Amount | 207818.63 |
| Total Medicare Allowed Amount | 77173.15 |
| Total Medicare Payment Amount | 57412.1 |
| Total Medicare Standardized Payment Amount | 60245.09 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 13 |
| Number Of Drug Services | 177 |
| Number Of Medicare Beneficiaries With Drug Services | 81 |
| Total Drug Submitted ChargeAmount | 5318 |
| Total Drug Medicare AllowedAmount | 3728.12 |
| Total Drug Medicare PaymentAmount | 3407.58 |
| Total Drug Medicare Standardized Payment Amount | 3407.58 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 133 |
| Number Of Medical Services | 2473 |
| Number Of Medicare Beneficiaries With Medical Services | 287 |
| Total Medical Submitted Charge Amount | 202500.63 |
| Total Medical Medicare Allowed Amount | 73445.03 |
| Total Medical Medicare Payment Amount | 54004.52 |
| Total Medical Medicare Standardized Payment Amount | 56837.51 |
| Average Age Of Beneficiaries | 65 |
| Number Of Beneficiaries Age Less65 | 104 |
| Number Of Beneficiaries Age 65 to 74 | 107 |
| Number Of Beneficiaries Age 75 to 84 | 51 |
| Number Of Beneficiaries Age Greater 84 | 25 |
| Number Of Female Beneficiaries | 164 |
| Number Of Male Beneficiaries | 123 |
| Number Of Non Hispanic White Beneficiaries | 272 |
| 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 | 198 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 89 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 59 |
| Percent Of With Ischemic Heart Disease | 22 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 26 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9192 |