| National Provider Identifier [NPI]: | 1215997168 |
| Last Name Of The Provider | WILL |
| First Name Of The Provider | ANDREW |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7235 OHMS LANE |
| Street Address 2 Of The Provider | |
| City Of The Provider | EDINA |
| Zip Code Of The Provider | 55439 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physical Medicine and Rehabilitation |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 82 |
| Number Of Services | 17316 |
| Number Of Medicare Beneficiaries | 591 |
| Total Submitted Charge Amount | 890457.8 |
| Total Medicare Allowed Amount | 297022.51 |
| Total Medicare Payment Amount | 215605.86 |
| Total Medicare Standardized Payment Amount | 223043.24 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 14 |
| Number Of Drug Services | 15111 |
| Number Of Medicare Beneficiaries With Drug Services | 105 |
| Total Drug Submitted ChargeAmount | 28019.8 |
| Total Drug Medicare AllowedAmount | 13613.66 |
| Total Drug Medicare PaymentAmount | 9976.06 |
| Total Drug Medicare Standardized Payment Amount | 9976.06 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 68 |
| Number Of Medical Services | 2205 |
| Number Of Medicare Beneficiaries With Medical Services | 591 |
| Total Medical Submitted Charge Amount | 862438 |
| Total Medical Medicare Allowed Amount | 283408.85 |
| Total Medical Medicare Payment Amount | 205629.8 |
| Total Medical Medicare Standardized Payment Amount | 213067.18 |
| Average Age Of Beneficiaries | 58 |
| Number Of Beneficiaries Age Less65 | 418 |
| Number Of Beneficiaries Age 65 to 74 | 93 |
| Number Of Beneficiaries Age 75 to 84 | 62 |
| Number Of Beneficiaries Age Greater 84 | 18 |
| Number Of Female Beneficiaries | 401 |
| Number Of Male Beneficiaries | 190 |
| Number Of Non Hispanic White Beneficiaries | 478 |
| Number Of Black or African American Beneficiaries | 72 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 17 |
| Number Of American Indian Alaska Native Beneficiaries | 11 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 296 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 295 |
| Percent Of With Atrial Fibrillation | 3 |
| Percent Of With Alzheimers Disease or Dementia | 2 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 8 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 54 |
| Percent Of With Diabetes | 20 |
| Percent Of With Hyperlipidemia | 29 |
| Percent Of With Hypertension | 45 |
| Percent Of With Ischemic Heart Disease | 18 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 55 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 2 |
| Average HCC Risk Score Of Beneficiaries | 1.3887 |