| National Provider Identifier [NPI]: | 1760454219 |
| Last Name Of The Provider | DROULLARD |
| First Name Of The Provider | ROBERT |
| 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 | 6845 LEE AVE N |
| Street Address 2 Of The Provider | |
| City Of The Provider | BROOKLYN CENTER |
| Zip Code Of The Provider | 554291717 |
| 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 | 62 |
| Number Of Services | 871 |
| Number Of Medicare Beneficiaries | 113 |
| Total Submitted Charge Amount | 99522 |
| Total Medicare Allowed Amount | 36626.48 |
| Total Medicare Payment Amount | 25157.26 |
| Total Medicare Standardized Payment Amount | 26446.45 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 245 |
| Number Of Medicare Beneficiaries With Drug Services | 35 |
| Total Drug Submitted ChargeAmount | 3378 |
| Total Drug Medicare AllowedAmount | 1752.08 |
| Total Drug Medicare PaymentAmount | 1311.22 |
| Total Drug Medicare Standardized Payment Amount | 1311.22 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 53 |
| Number Of Medical Services | 626 |
| Number Of Medicare Beneficiaries With Medical Services | 113 |
| Total Medical Submitted Charge Amount | 96144 |
| Total Medical Medicare Allowed Amount | 34874.4 |
| Total Medical Medicare Payment Amount | 23846.04 |
| Total Medical Medicare Standardized Payment Amount | 25135.23 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 36 |
| Number Of Beneficiaries Age 65 to 74 | 44 |
| Number Of Beneficiaries Age 75 to 84 | 21 |
| Number Of Beneficiaries Age Greater 84 | 12 |
| Number Of Female Beneficiaries | 62 |
| Number Of Male Beneficiaries | 51 |
| Number Of Non Hispanic White Beneficiaries | 74 |
| Number Of Black or African American Beneficiaries | 25 |
| 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 | 72 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 41 |
| 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 | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 27 |
| Percent Of With Hypertension | 49 |
| Percent Of With Ischemic Heart Disease | 19 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 22 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9732 |