| National Provider Identifier [NPI]: | 1639285117 |
| Last Name Of The Provider | GOSSARD |
| First Name Of The Provider | LAURIE |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 484 COUNTY LINE RD W |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | WESTERVILLE |
| Zip Code Of The Provider | 430827080 |
| 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 | 149 |
| Number Of Services | 6344 |
| Number Of Medicare Beneficiaries | 299 |
| Total Submitted Charge Amount | 261575 |
| Total Medicare Allowed Amount | 149015.82 |
| Total Medicare Payment Amount | 121950.21 |
| Total Medicare Standardized Payment Amount | 125455.11 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 1488 |
| Number Of Medicare Beneficiaries With Drug Services | 139 |
| Total Drug Submitted ChargeAmount | 8621 |
| Total Drug Medicare AllowedAmount | 5913.8 |
| Total Drug Medicare PaymentAmount | 5701.87 |
| Total Drug Medicare Standardized Payment Amount | 5701.87 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 141 |
| Number Of Medical Services | 4856 |
| Number Of Medicare Beneficiaries With Medical Services | 299 |
| Total Medical Submitted Charge Amount | 252954 |
| Total Medical Medicare Allowed Amount | 143102.02 |
| Total Medical Medicare Payment Amount | 116248.34 |
| Total Medical Medicare Standardized Payment Amount | 119753.24 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 11 |
| Number Of Beneficiaries Age 65 to 74 | 156 |
| Number Of Beneficiaries Age 75 to 84 | 91 |
| Number Of Beneficiaries Age Greater 84 | 41 |
| Number Of Female Beneficiaries | 213 |
| Number Of Male Beneficiaries | 86 |
| Number Of Non Hispanic White Beneficiaries | 278 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| 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 | 283 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 16 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 21 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.9462 |