| National Provider Identifier [NPI]: | 1629015177 |
| Last Name Of The Provider | BOELTER |
| First Name Of The Provider | NANCY |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3701 KATZ DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | MARION |
| Zip Code Of The Provider | 523023871 |
| 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 | 44 |
| Number Of Services | 685 |
| Number Of Medicare Beneficiaries | 150 |
| Total Submitted Charge Amount | 58645 |
| Total Medicare Allowed Amount | 29436.78 |
| Total Medicare Payment Amount | 22911.88 |
| Total Medicare Standardized Payment Amount | 24567.9 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 50 |
| Number Of Medicare Beneficiaries With Drug Services | 46 |
| Total Drug Submitted ChargeAmount | 2537 |
| Total Drug Medicare AllowedAmount | 1955.64 |
| Total Drug Medicare PaymentAmount | 1916.27 |
| Total Drug Medicare Standardized Payment Amount | 1916.27 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 39 |
| Number Of Medical Services | 635 |
| Number Of Medicare Beneficiaries With Medical Services | 150 |
| Total Medical Submitted Charge Amount | 56108 |
| Total Medical Medicare Allowed Amount | 27481.14 |
| Total Medical Medicare Payment Amount | 20995.61 |
| Total Medical Medicare Standardized Payment Amount | 22651.63 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 17 |
| Number Of Beneficiaries Age 65 to 74 | 77 |
| Number Of Beneficiaries Age 75 to 84 | 40 |
| Number Of Beneficiaries Age Greater 84 | 16 |
| Number Of Female Beneficiaries | 99 |
| Number Of Male Beneficiaries | 51 |
| 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 | 128 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 22 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 28 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.7199 |