| National Provider Identifier [NPI]: | 1689761991 |
| Last Name Of The Provider | WOLERY |
| First Name Of The Provider | LAURA |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4351 DALE DR |
| Street Address 2 Of The Provider | ST 200 |
| City Of The Provider | DUBLIN |
| Zip Code Of The Provider | 43017 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 25 |
| Number Of Services | 533 |
| Number Of Medicare Beneficiaries | 66 |
| Total Submitted Charge Amount | 32464 |
| Total Medicare Allowed Amount | 23627.5 |
| Total Medicare Payment Amount | 16217.59 |
| Total Medicare Standardized Payment Amount | 17144.68 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 52 |
| Number Of Medicare Beneficiaries With Drug Services | 26 |
| Total Drug Submitted ChargeAmount | 1349 |
| Total Drug Medicare AllowedAmount | 830.22 |
| Total Drug Medicare PaymentAmount | 790.84 |
| Total Drug Medicare Standardized Payment Amount | 790.84 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 18 |
| Number Of Medical Services | 481 |
| Number Of Medicare Beneficiaries With Medical Services | 66 |
| Total Medical Submitted Charge Amount | 31115 |
| Total Medical Medicare Allowed Amount | 22797.28 |
| Total Medical Medicare Payment Amount | 15426.75 |
| Total Medical Medicare Standardized Payment Amount | 16353.84 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 44 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 47 |
| Number Of Male Beneficiaries | 19 |
| 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 | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | 0 |
| Percent Of With Depression | |
| Percent Of With Diabetes | 17 |
| Percent Of With Hyperlipidemia | 27 |
| Percent Of With Hypertension | 32 |
| Percent Of With Ischemic Heart Disease | 18 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 0 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.7078 |