| National Provider Identifier [NPI]: | 1568468569 |
| Last Name Of The Provider | LONGSDORF |
| First Name Of The Provider | KATHERINE |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1050 DAUCH DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | ASHLAND |
| Zip Code Of The Provider | 448058845 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 21 |
| Number Of Services | 453 |
| Number Of Medicare Beneficiaries | 178 |
| Total Submitted Charge Amount | 47721 |
| Total Medicare Allowed Amount | 31728.58 |
| Total Medicare Payment Amount | 19497.46 |
| Total Medicare Standardized Payment Amount | 20430.17 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 18 |
| Number Of Medicare Beneficiaries With Drug Services | 18 |
| Total Drug Submitted ChargeAmount | 414 |
| Total Drug Medicare AllowedAmount | 280.43 |
| Total Drug Medicare PaymentAmount | 274.79 |
| Total Drug Medicare Standardized Payment Amount | 274.79 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 18 |
| Number Of Medical Services | 435 |
| Number Of Medicare Beneficiaries With Medical Services | 178 |
| Total Medical Submitted Charge Amount | 47307 |
| Total Medical Medicare Allowed Amount | 31448.15 |
| Total Medical Medicare Payment Amount | 19222.67 |
| Total Medical Medicare Standardized Payment Amount | 20155.38 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 27 |
| Number Of Beneficiaries Age 65 to 74 | 76 |
| Number Of Beneficiaries Age 75 to 84 | 42 |
| Number Of Beneficiaries Age Greater 84 | 33 |
| Number Of Female Beneficiaries | 107 |
| Number Of Male Beneficiaries | 71 |
| 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 | 145 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 33 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 6 |
| Percent Of With Chronic Kidney Disease | 8 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 28 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 27 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8589 |