| National Provider Identifier [NPI]: | 1821259110 |
| Last Name Of The Provider | HAMP |
| First Name Of The Provider | ANDREW |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3850 PARK NICOLLET BLVD |
| Street Address 2 Of The Provider | INTERNAL MEDICINE CLINIC |
| City Of The Provider | ST LOUIS PARK |
| Zip Code Of The Provider | 554162527 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 73 |
| Number Of Services | 1545 |
| Number Of Medicare Beneficiaries | 315 |
| Total Submitted Charge Amount | 158521.18 |
| Total Medicare Allowed Amount | 70263.66 |
| Total Medicare Payment Amount | 53598.98 |
| Total Medicare Standardized Payment Amount | 54992.24 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 76 |
| Number Of Medicare Beneficiaries With Drug Services | 60 |
| Total Drug Submitted ChargeAmount | 4320 |
| Total Drug Medicare AllowedAmount | 2887.28 |
| Total Drug Medicare PaymentAmount | 2823.63 |
| Total Drug Medicare Standardized Payment Amount | 2823.63 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 68 |
| Number Of Medical Services | 1469 |
| Number Of Medicare Beneficiaries With Medical Services | 315 |
| Total Medical Submitted Charge Amount | 154201.18 |
| Total Medical Medicare Allowed Amount | 67376.38 |
| Total Medical Medicare Payment Amount | 50775.35 |
| Total Medical Medicare Standardized Payment Amount | 52168.61 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 60 |
| Number Of Beneficiaries Age 65 to 74 | 69 |
| Number Of Beneficiaries Age 75 to 84 | 94 |
| Number Of Beneficiaries Age Greater 84 | 92 |
| Number Of Female Beneficiaries | 168 |
| Number Of Male Beneficiaries | 147 |
| Number Of Non Hispanic White Beneficiaries | 281 |
| Number Of Black or African American Beneficiaries | 18 |
| 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 | 233 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 82 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 27 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 40 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 15 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.7745 |