| National Provider Identifier [NPI]: | 1700939311 |
| Last Name Of The Provider | ROSENQUIST |
| First Name Of The Provider | MARY |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 123 MEDICAL PARK LN STE A |
| Street Address 2 Of The Provider | |
| City Of The Provider | HUNTSVILLE |
| Zip Code Of The Provider | 773404981 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 117 |
| Number Of Services | 8118 |
| Number Of Medicare Beneficiaries | 573 |
| Total Submitted Charge Amount | 559995 |
| Total Medicare Allowed Amount | 326814.43 |
| Total Medicare Payment Amount | 238257.39 |
| Total Medicare Standardized Payment Amount | 252935.26 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 994 |
| Number Of Medicare Beneficiaries With Drug Services | 392 |
| Total Drug Submitted ChargeAmount | 51985 |
| Total Drug Medicare AllowedAmount | 36472.97 |
| Total Drug Medicare PaymentAmount | 34506.57 |
| Total Drug Medicare Standardized Payment Amount | 34506.57 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 106 |
| Number Of Medical Services | 7124 |
| Number Of Medicare Beneficiaries With Medical Services | 573 |
| Total Medical Submitted Charge Amount | 508010 |
| Total Medical Medicare Allowed Amount | 290341.46 |
| Total Medical Medicare Payment Amount | 203750.82 |
| Total Medical Medicare Standardized Payment Amount | 218428.69 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 11 |
| Number Of Beneficiaries Age 65 to 74 | 272 |
| Number Of Beneficiaries Age 75 to 84 | 191 |
| Number Of Beneficiaries Age Greater 84 | 99 |
| Number Of Female Beneficiaries | 395 |
| Number Of Male Beneficiaries | 178 |
| Number Of Non Hispanic White Beneficiaries | 489 |
| Number Of Black or African American Beneficiaries | 51 |
| 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 | 524 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 49 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.1353 |