| National Provider Identifier [NPI]: | 1922083799 |
| Last Name Of The Provider | FUNK |
| First Name Of The Provider | EDWIN |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | |
| 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 | |
| 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 | 46 |
| Number Of Services | 289 |
| Number Of Medicare Beneficiaries | 142 |
| Total Submitted Charge Amount | 25915 |
| Total Medicare Allowed Amount | 11034.53 |
| Total Medicare Payment Amount | 7757.82 |
| Total Medicare Standardized Payment Amount | 7999.27 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 75 |
| Number Of Medicare Beneficiaries With Drug Services | 19 |
| Total Drug Submitted ChargeAmount | 261 |
| Total Drug Medicare AllowedAmount | 106.53 |
| Total Drug Medicare PaymentAmount | 86.74 |
| Total Drug Medicare Standardized Payment Amount | 86.74 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 36 |
| Number Of Medical Services | 214 |
| Number Of Medicare Beneficiaries With Medical Services | 142 |
| Total Medical Submitted Charge Amount | 25654 |
| Total Medical Medicare Allowed Amount | 10928 |
| Total Medical Medicare Payment Amount | 7671.08 |
| Total Medical Medicare Standardized Payment Amount | 7912.53 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 44 |
| Number Of Beneficiaries Age 65 to 74 | 36 |
| Number Of Beneficiaries Age 75 to 84 | 41 |
| Number Of Beneficiaries Age Greater 84 | 21 |
| Number Of Female Beneficiaries | 101 |
| Number Of Male Beneficiaries | 41 |
| Number Of Non Hispanic White Beneficiaries | 131 |
| Number Of Black or African American Beneficiaries | |
| 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 | 102 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 40 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 34 |
| Percent Of With Hypertension | 46 |
| Percent Of With Ischemic Heart Disease | 23 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.1995 |