| National Provider Identifier [NPI]: | 1306049010 |
| Last Name Of The Provider | MENSER |
| First Name Of The Provider | MOLLY |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1805 NW PLATTE RD |
| Street Address 2 Of The Provider | SUITE 120 |
| City Of The Provider | RIVERSIDE |
| Zip Code Of The Provider | 641509613 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 27 |
| Number Of Services | 1309 |
| Number Of Medicare Beneficiaries | 253 |
| Total Submitted Charge Amount | 151639 |
| Total Medicare Allowed Amount | 99899.21 |
| Total Medicare Payment Amount | 69519.71 |
| Total Medicare Standardized Payment Amount | 71475.55 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 121 |
| Number Of Medicare Beneficiaries With Drug Services | 41 |
| Total Drug Submitted ChargeAmount | 14432 |
| Total Drug Medicare AllowedAmount | 11016.77 |
| Total Drug Medicare PaymentAmount | 7721.34 |
| Total Drug Medicare Standardized Payment Amount | 7721.34 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 25 |
| Number Of Medical Services | 1188 |
| Number Of Medicare Beneficiaries With Medical Services | 253 |
| Total Medical Submitted Charge Amount | 137207 |
| Total Medical Medicare Allowed Amount | 88882.44 |
| Total Medical Medicare Payment Amount | 61798.37 |
| Total Medical Medicare Standardized Payment Amount | 63754.21 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 22 |
| Number Of Beneficiaries Age 65 to 74 | 131 |
| Number Of Beneficiaries Age 75 to 84 | 73 |
| Number Of Beneficiaries Age Greater 84 | 27 |
| Number Of Female Beneficiaries | 189 |
| Number Of Male Beneficiaries | 64 |
| Number Of Non Hispanic White Beneficiaries | 241 |
| 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 | 240 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 13 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 4 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 58 |
| Percent Of With Ischemic Heart Disease | 28 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0287 |