| National Provider Identifier [NPI]: | 1922089937 |
| Last Name Of The Provider | WESTERDAHL |
| First Name Of The Provider | JOY |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1495 HWY 101 N |
| Street Address 2 Of The Provider | |
| City Of The Provider | PLYMOUTH |
| Zip Code Of The Provider | 55447 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 113 |
| Number Of Services | 1486 |
| Number Of Medicare Beneficiaries | 159 |
| Total Submitted Charge Amount | 129894 |
| Total Medicare Allowed Amount | 51697.14 |
| Total Medicare Payment Amount | 38956.23 |
| Total Medicare Standardized Payment Amount | 40365.95 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 439 |
| Number Of Medicare Beneficiaries With Drug Services | 36 |
| Total Drug Submitted ChargeAmount | 2686 |
| Total Drug Medicare AllowedAmount | 1187.91 |
| Total Drug Medicare PaymentAmount | 1136.06 |
| Total Drug Medicare Standardized Payment Amount | 1136.06 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 109 |
| Number Of Medical Services | 1047 |
| Number Of Medicare Beneficiaries With Medical Services | 159 |
| Total Medical Submitted Charge Amount | 127208 |
| Total Medical Medicare Allowed Amount | 50509.23 |
| Total Medical Medicare Payment Amount | 37820.17 |
| Total Medical Medicare Standardized Payment Amount | 39229.89 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 43 |
| Number Of Beneficiaries Age 65 to 74 | 51 |
| Number Of Beneficiaries Age 75 to 84 | 41 |
| Number Of Beneficiaries Age Greater 84 | 24 |
| Number Of Female Beneficiaries | 111 |
| Number Of Male Beneficiaries | 48 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| 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 | |
| Number Of Beneficiaries With Medicare Only Entitlement | 119 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 40 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 53 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.342 |