| National Provider Identifier [NPI]: | 1104920107 |
| Last Name Of The Provider | OLDENBURG |
| First Name Of The Provider | LAURA |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | PA |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2323 N MAYFAIR RD |
| Street Address 2 Of The Provider | SUITE 310 |
| City Of The Provider | MILWAUKEE |
| Zip Code Of The Provider | 532261506 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 37 |
| Number Of Services | 899 |
| Number Of Medicare Beneficiaries | 282 |
| Total Submitted Charge Amount | 212310 |
| Total Medicare Allowed Amount | 42553.41 |
| Total Medicare Payment Amount | 31506.93 |
| Total Medicare Standardized Payment Amount | 36514.05 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 223 |
| Number Of Medicare Beneficiaries With Drug Services | 131 |
| Total Drug Submitted ChargeAmount | 28857 |
| Total Drug Medicare AllowedAmount | 7187.38 |
| Total Drug Medicare PaymentAmount | 5604.66 |
| Total Drug Medicare Standardized Payment Amount | 5604.66 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 33 |
| Number Of Medical Services | 676 |
| Number Of Medicare Beneficiaries With Medical Services | 282 |
| Total Medical Submitted Charge Amount | 183453 |
| Total Medical Medicare Allowed Amount | 35366.03 |
| Total Medical Medicare Payment Amount | 25902.27 |
| Total Medical Medicare Standardized Payment Amount | 30909.39 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 47 |
| Number Of Beneficiaries Age 65 to 74 | 111 |
| Number Of Beneficiaries Age 75 to 84 | 93 |
| Number Of Beneficiaries Age Greater 84 | 31 |
| Number Of Female Beneficiaries | 177 |
| Number Of Male Beneficiaries | 105 |
| Number Of Non Hispanic White Beneficiaries | 240 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 19 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 225 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 57 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.2049 |