| National Provider Identifier [NPI]: | 1417934605 |
| Last Name Of The Provider | BORKON |
| First Name Of The Provider | WILLIAM |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3900 PARK NICOLLET BLVD |
| Street Address 2 Of The Provider | UROLOGY DEPT |
| City Of The Provider | ST LOUIS PARK |
| Zip Code Of The Provider | 554162503 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 59 |
| Number Of Services | 811 |
| Number Of Medicare Beneficiaries | 243 |
| Total Submitted Charge Amount | 205739.41 |
| Total Medicare Allowed Amount | 75743.68 |
| Total Medicare Payment Amount | 55742.44 |
| Total Medicare Standardized Payment Amount | 57114.69 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 156 |
| Number Of Medicare Beneficiaries With Drug Services | 13 |
| Total Drug Submitted ChargeAmount | 22481 |
| Total Drug Medicare AllowedAmount | 9352.59 |
| Total Drug Medicare PaymentAmount | 7285.07 |
| Total Drug Medicare Standardized Payment Amount | 7285.07 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 55 |
| Number Of Medical Services | 655 |
| Number Of Medicare Beneficiaries With Medical Services | 243 |
| Total Medical Submitted Charge Amount | 183258.41 |
| Total Medical Medicare Allowed Amount | 66391.09 |
| Total Medical Medicare Payment Amount | 48457.37 |
| Total Medical Medicare Standardized Payment Amount | 49829.62 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 25 |
| Number Of Beneficiaries Age 65 to 74 | 91 |
| Number Of Beneficiaries Age 75 to 84 | 84 |
| Number Of Beneficiaries Age Greater 84 | 43 |
| Number Of Female Beneficiaries | 29 |
| Number Of Male Beneficiaries | 214 |
| Number Of Non Hispanic White Beneficiaries | 229 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 0 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 213 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 30 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 44 |
| Percent Of With Hypertension | 52 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 23 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1519 |