| National Provider Identifier [NPI]: | 1518967645 |
| Last Name Of The Provider | EDINBURGH |
| First Name Of The Provider | KEITH |
| 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 | 3300 OAKDALE AVE N |
| Street Address 2 Of The Provider | |
| City Of The Provider | ROBBINSDALE |
| Zip Code Of The Provider | 554222926 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 153 |
| Number Of Services | 7708 |
| Number Of Medicare Beneficiaries | 2541 |
| Total Submitted Charge Amount | 586006.05 |
| Total Medicare Allowed Amount | 175579.84 |
| Total Medicare Payment Amount | 134115.4 |
| Total Medicare Standardized Payment Amount | 138245.16 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 3342 |
| Number Of Medicare Beneficiaries With Drug Services | 34 |
| Total Drug Submitted ChargeAmount | 3436.05 |
| Total Drug Medicare AllowedAmount | 672 |
| Total Drug Medicare PaymentAmount | 499.4 |
| Total Drug Medicare Standardized Payment Amount | 499.4 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 148 |
| Number Of Medical Services | 4366 |
| Number Of Medicare Beneficiaries With Medical Services | 2541 |
| Total Medical Submitted Charge Amount | 582570 |
| Total Medical Medicare Allowed Amount | 174907.84 |
| Total Medical Medicare Payment Amount | 133616 |
| Total Medical Medicare Standardized Payment Amount | 137745.76 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 803 |
| Number Of Beneficiaries Age 65 to 74 | 678 |
| Number Of Beneficiaries Age 75 to 84 | 672 |
| Number Of Beneficiaries Age Greater 84 | 388 |
| Number Of Female Beneficiaries | 1605 |
| Number Of Male Beneficiaries | 936 |
| Number Of Non Hispanic White Beneficiaries | 2081 |
| Number Of Black or African American Beneficiaries | 321 |
| Number Of AsianPacific Islander Beneficiaries | 48 |
| Number Of Hispanic Beneficiaries | 32 |
| Number Of American Indian Alaska Native Beneficiaries | 24 |
| Number Of Beneficiaries With Race Not Else where Classified | 35 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1637 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 904 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 37 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 12 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.6723 |