| National Provider Identifier [NPI]: | 1689753345 |
| Last Name Of The Provider | NEEDHAM |
| First Name Of The Provider | ROBERT |
| Middle Initial Of The Provider | N |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 424 W STATE HIGHWAY 5 |
| Street Address 2 Of The Provider | |
| City Of The Provider | WACONIA |
| Zip Code Of The Provider | 553871723 |
| 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 | 83 |
| Number Of Services | 1454 |
| Number Of Medicare Beneficiaries | 428 |
| Total Submitted Charge Amount | 57897.46 |
| Total Medicare Allowed Amount | 51476.2 |
| Total Medicare Payment Amount | 38476.15 |
| Total Medicare Standardized Payment Amount | 38931.46 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 34 |
| Number Of Medicare Beneficiaries With Drug Services | 19 |
| Total Drug Submitted ChargeAmount | 1309.27 |
| Total Drug Medicare AllowedAmount | 956.02 |
| Total Drug Medicare PaymentAmount | 929.36 |
| Total Drug Medicare Standardized Payment Amount | 929.36 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 76 |
| Number Of Medical Services | 1420 |
| Number Of Medicare Beneficiaries With Medical Services | 428 |
| Total Medical Submitted Charge Amount | 56588.19 |
| Total Medical Medicare Allowed Amount | 50520.18 |
| Total Medical Medicare Payment Amount | 37546.79 |
| Total Medical Medicare Standardized Payment Amount | 38002.1 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 82 |
| Number Of Beneficiaries Age 65 to 74 | 107 |
| Number Of Beneficiaries Age 75 to 84 | 137 |
| Number Of Beneficiaries Age Greater 84 | 102 |
| Number Of Female Beneficiaries | 228 |
| Number Of Male Beneficiaries | 200 |
| 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 | 341 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 87 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 36 |
| Percent Of With Hypertension | 58 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 12 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.1541 |