| National Provider Identifier [NPI]: | 1881858363 |
| Last Name Of The Provider | BRODER |
| First Name Of The Provider | LAURA |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 420 DELAWARE ST SE |
| Street Address 2 Of The Provider | MMC 284 |
| City Of The Provider | MINNEAPOLIS |
| Zip Code Of The Provider | 554550341 |
| 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 | 72 |
| Number Of Services | 2070 |
| Number Of Medicare Beneficiaries | 219 |
| Total Submitted Charge Amount | 118152.65 |
| Total Medicare Allowed Amount | 51009.27 |
| Total Medicare Payment Amount | 37870.98 |
| Total Medicare Standardized Payment Amount | 39333.7 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 727 |
| Number Of Medicare Beneficiaries With Drug Services | 51 |
| Total Drug Submitted ChargeAmount | 11092 |
| Total Drug Medicare AllowedAmount | 5769.27 |
| Total Drug Medicare PaymentAmount | 5164.21 |
| Total Drug Medicare Standardized Payment Amount | 5164.21 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 61 |
| Number Of Medical Services | 1343 |
| Number Of Medicare Beneficiaries With Medical Services | 219 |
| Total Medical Submitted Charge Amount | 107060.65 |
| Total Medical Medicare Allowed Amount | 45240 |
| Total Medical Medicare Payment Amount | 32706.77 |
| Total Medical Medicare Standardized Payment Amount | 34169.49 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 43 |
| Number Of Beneficiaries Age 65 to 74 | 95 |
| Number Of Beneficiaries Age 75 to 84 | 54 |
| Number Of Beneficiaries Age Greater 84 | 27 |
| Number Of Female Beneficiaries | 134 |
| Number Of Male Beneficiaries | 85 |
| Number Of Non Hispanic White Beneficiaries | 204 |
| 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 | 181 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 38 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 40 |
| Percent Of With Hypertension | 59 |
| Percent Of With Ischemic Heart Disease | 19 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.2535 |