| National Provider Identifier [NPI]: | 1811085848 |
| Last Name Of The Provider | LANGE |
| First Name Of The Provider | KATHLEEN |
| 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 | 707 S MAIN ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | CENTERVILLE |
| Zip Code Of The Provider | 525442421 |
| 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 | 66 |
| Number Of Services | 7153 |
| Number Of Medicare Beneficiaries | 866 |
| Total Submitted Charge Amount | 706352.43 |
| Total Medicare Allowed Amount | 263661.63 |
| Total Medicare Payment Amount | 178292.34 |
| Total Medicare Standardized Payment Amount | 195549.87 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 17 |
| Number Of Drug Services | 1465 |
| Number Of Medicare Beneficiaries With Drug Services | 428 |
| Total Drug Submitted ChargeAmount | 82945.5 |
| Total Drug Medicare AllowedAmount | 11405.92 |
| Total Drug Medicare PaymentAmount | 8934.13 |
| Total Drug Medicare Standardized Payment Amount | 8934.13 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 49 |
| Number Of Medical Services | 5688 |
| Number Of Medicare Beneficiaries With Medical Services | 865 |
| Total Medical Submitted Charge Amount | 623406.93 |
| Total Medical Medicare Allowed Amount | 252255.71 |
| Total Medical Medicare Payment Amount | 169358.21 |
| Total Medical Medicare Standardized Payment Amount | 186615.74 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 85 |
| Number Of Beneficiaries Age 65 to 74 | 393 |
| Number Of Beneficiaries Age 75 to 84 | 248 |
| Number Of Beneficiaries Age Greater 84 | 140 |
| Number Of Female Beneficiaries | 539 |
| Number Of Male Beneficiaries | 327 |
| Number Of Non Hispanic White Beneficiaries | 855 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| 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 | 700 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 166 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 32 |
| Percent Of With Hypertension | 62 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.044 |