| National Provider Identifier [NPI]: | 1225098353 |
| Last Name Of The Provider | ZAUN |
| First Name Of The Provider | SHELLEY |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1055 CENTERVILLE CIR |
| Street Address 2 Of The Provider | |
| City Of The Provider | VADNAIS HEIGHTS |
| Zip Code Of The Provider | 551275033 |
| 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 | 60 |
| Number Of Services | 748 |
| Number Of Medicare Beneficiaries | 80 |
| Total Submitted Charge Amount | 45971.61 |
| Total Medicare Allowed Amount | 21534.32 |
| Total Medicare Payment Amount | 15468.57 |
| Total Medicare Standardized Payment Amount | 16106.51 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 211 |
| Number Of Medicare Beneficiaries With Drug Services | 29 |
| Total Drug Submitted ChargeAmount | 3182.61 |
| Total Drug Medicare AllowedAmount | 2524.97 |
| Total Drug Medicare PaymentAmount | 2263.89 |
| Total Drug Medicare Standardized Payment Amount | 2263.89 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 50 |
| Number Of Medical Services | 537 |
| Number Of Medicare Beneficiaries With Medical Services | 80 |
| Total Medical Submitted Charge Amount | 42789 |
| Total Medical Medicare Allowed Amount | 19009.35 |
| Total Medical Medicare Payment Amount | 13204.68 |
| Total Medical Medicare Standardized Payment Amount | 13842.62 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 16 |
| Number Of Beneficiaries Age 65 to 74 | 26 |
| Number Of Beneficiaries Age 75 to 84 | 25 |
| Number Of Beneficiaries Age Greater 84 | 13 |
| Number Of Female Beneficiaries | 66 |
| Number Of Male Beneficiaries | 14 |
| 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 | 64 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 16 |
| 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 | 14 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 21 |
| Percent Of With Hyperlipidemia | 34 |
| Percent Of With Hypertension | 53 |
| Percent Of With Ischemic Heart Disease | 16 |
| Percent Of With Osteoporosis | 18 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.994 |