| National Provider Identifier [NPI]: | 1710079322 |
| Last Name Of The Provider | NASSTROM |
| First Name Of The Provider | JEFFREY |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 620 N 8TH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | OSAGE |
| Zip Code Of The Provider | 504611456 |
| 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 | 26 |
| Number Of Services | 564 |
| Number Of Medicare Beneficiaries | 199 |
| Total Submitted Charge Amount | 76790.5 |
| Total Medicare Allowed Amount | 35196.39 |
| Total Medicare Payment Amount | 27507.94 |
| Total Medicare Standardized Payment Amount | 29160.59 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 26 |
| Number Of Medical Services | 564 |
| Number Of Medicare Beneficiaries With Medical Services | 199 |
| Total Medical Submitted Charge Amount | 76790.5 |
| Total Medical Medicare Allowed Amount | 35196.39 |
| Total Medical Medicare Payment Amount | 27507.94 |
| Total Medical Medicare Standardized Payment Amount | 29160.59 |
| Average Age Of Beneficiaries | 79 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | |
| Number Of Beneficiaries Age 75 to 84 | 74 |
| Number Of Beneficiaries Age Greater 84 | 60 |
| Number Of Female Beneficiaries | 121 |
| Number Of Male Beneficiaries | 78 |
| Number Of Non Hispanic White Beneficiaries | 199 |
| Number Of Black or African American Beneficiaries | 0 |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| Number Of Hispanic Beneficiaries | 0 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 0 |
| Number Of Beneficiaries With Medicare Only Entitlement | 163 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 36 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 31 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 19 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.1812 |