| National Provider Identifier [NPI]: | 1033201181 |
| Last Name Of The Provider | STOCKDALE |
| First Name Of The Provider | ROBERT |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2900 12TH AVE N |
| Street Address 2 Of The Provider | STE 503E |
| City Of The Provider | BILLINGS |
| Zip Code Of The Provider | 59101 |
| State Code Of The Provider | MT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 59 |
| Number Of Services | 2577 |
| Number Of Medicare Beneficiaries | 865 |
| Total Submitted Charge Amount | 586390.66 |
| Total Medicare Allowed Amount | 242644.54 |
| Total Medicare Payment Amount | 174730.56 |
| Total Medicare Standardized Payment Amount | 173916.29 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 165 |
| Number Of Medicare Beneficiaries With Drug Services | 31 |
| Total Drug Submitted ChargeAmount | 133889 |
| Total Drug Medicare AllowedAmount | 26192.63 |
| Total Drug Medicare PaymentAmount | 19886.35 |
| Total Drug Medicare Standardized Payment Amount | 19886.35 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 54 |
| Number Of Medical Services | 2412 |
| Number Of Medicare Beneficiaries With Medical Services | 865 |
| Total Medical Submitted Charge Amount | 452501.66 |
| Total Medical Medicare Allowed Amount | 216451.91 |
| Total Medical Medicare Payment Amount | 154844.21 |
| Total Medical Medicare Standardized Payment Amount | 154029.94 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 46 |
| Number Of Beneficiaries Age 65 to 74 | 370 |
| Number Of Beneficiaries Age 75 to 84 | 324 |
| Number Of Beneficiaries Age Greater 84 | 125 |
| Number Of Female Beneficiaries | 155 |
| Number Of Male Beneficiaries | 710 |
| Number Of Non Hispanic White Beneficiaries | 817 |
| 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 | 20 |
| Number Of Beneficiaries With Medicare Only Entitlement | 801 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 64 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 34 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 39 |
| Percent Of With Hypertension | 54 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | 3 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0913 |