| National Provider Identifier [NPI]: | 1548248479 |
| Last Name Of The Provider | ZAPZALKA |
| First Name Of The Provider | DANIEL |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3900 PARK NICOLLET BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | ST LOUIS PARK |
| Zip Code Of The Provider | 554162503 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 74 |
| Number Of Services | 1220 |
| Number Of Medicare Beneficiaries | 359 |
| Total Submitted Charge Amount | 352486.45 |
| Total Medicare Allowed Amount | 128511.32 |
| Total Medicare Payment Amount | 95463.42 |
| Total Medicare Standardized Payment Amount | 97896.02 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 106 |
| Number Of Medicare Beneficiaries With Drug Services | 26 |
| Total Drug Submitted ChargeAmount | 41318 |
| Total Drug Medicare AllowedAmount | 17820.39 |
| Total Drug Medicare PaymentAmount | 13847.24 |
| Total Drug Medicare Standardized Payment Amount | 13847.24 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 70 |
| Number Of Medical Services | 1114 |
| Number Of Medicare Beneficiaries With Medical Services | 359 |
| Total Medical Submitted Charge Amount | 311168.45 |
| Total Medical Medicare Allowed Amount | 110690.93 |
| Total Medical Medicare Payment Amount | 81616.18 |
| Total Medical Medicare Standardized Payment Amount | 84048.78 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 49 |
| Number Of Beneficiaries Age 65 to 74 | 147 |
| Number Of Beneficiaries Age 75 to 84 | 98 |
| Number Of Beneficiaries Age Greater 84 | 65 |
| Number Of Female Beneficiaries | 58 |
| Number Of Male Beneficiaries | 301 |
| Number Of Non Hispanic White Beneficiaries | 317 |
| Number Of Black or African American Beneficiaries | 16 |
| 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 | 11 |
| Number Of Beneficiaries With Medicare Only Entitlement | 310 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 49 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 27 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 43 |
| Percent Of With Hypertension | 55 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 30 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.2102 |