| National Provider Identifier [NPI]: | 1508809930 |
| Last Name Of The Provider | GREGERSON |
| First Name Of The Provider | MARK |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1805 HENNEPIN AVE N |
| Street Address 2 Of The Provider | |
| City Of The Provider | GLENCOE |
| Zip Code Of The Provider | 553361416 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 28 |
| Number Of Services | 164 |
| Number Of Medicare Beneficiaries | 73 |
| Total Submitted Charge Amount | 151784.46 |
| Total Medicare Allowed Amount | 38793.05 |
| Total Medicare Payment Amount | 30379.25 |
| Total Medicare Standardized Payment Amount | 32000.09 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 32 |
| Number Of Medicare Beneficiaries With Drug Services | 12 |
| Total Drug Submitted ChargeAmount | 3899.08 |
| Total Drug Medicare AllowedAmount | 543.45 |
| Total Drug Medicare PaymentAmount | 417.11 |
| Total Drug Medicare Standardized Payment Amount | 417.11 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 26 |
| Number Of Medical Services | 132 |
| Number Of Medicare Beneficiaries With Medical Services | 72 |
| Total Medical Submitted Charge Amount | 147885.38 |
| Total Medical Medicare Allowed Amount | 38249.6 |
| Total Medical Medicare Payment Amount | 29962.14 |
| Total Medical Medicare Standardized Payment Amount | 31582.98 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 18 |
| Number Of Beneficiaries Age 65 to 74 | 18 |
| Number Of Beneficiaries Age 75 to 84 | 25 |
| Number Of Beneficiaries Age Greater 84 | 12 |
| Number Of Female Beneficiaries | 49 |
| Number Of Male Beneficiaries | 24 |
| 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 | 51 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 22 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 33 |
| Percent Of With Hypertension | 60 |
| Percent Of With Ischemic Heart Disease | 23 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 58 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.178 |