| National Provider Identifier [NPI]: | 1174650816 |
| Last Name Of The Provider | HANSEN |
| First Name Of The Provider | KAREN |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | PA-C |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1230 E MAIN STREET |
| Street Address 2 Of The Provider | MANKATO CLINIC AT MAIN STREET |
| City Of The Provider | MANKATO |
| Zip Code Of The Provider | 560028674 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 61 |
| Number Of Services | 517 |
| Number Of Medicare Beneficiaries | 194 |
| Total Submitted Charge Amount | 53624.02 |
| Total Medicare Allowed Amount | 20591.32 |
| Total Medicare Payment Amount | 14754.15 |
| Total Medicare Standardized Payment Amount | 17708.35 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 41 |
| Number Of Medicare Beneficiaries With Drug Services | 15 |
| Total Drug Submitted ChargeAmount | 904.78 |
| Total Drug Medicare AllowedAmount | 317.02 |
| Total Drug Medicare PaymentAmount | 268.15 |
| Total Drug Medicare Standardized Payment Amount | 268.15 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 54 |
| Number Of Medical Services | 476 |
| Number Of Medicare Beneficiaries With Medical Services | 194 |
| Total Medical Submitted Charge Amount | 52719.24 |
| Total Medical Medicare Allowed Amount | 20274.3 |
| Total Medical Medicare Payment Amount | 14486 |
| Total Medical Medicare Standardized Payment Amount | 17440.2 |
| Average Age Of Beneficiaries | 61 |
| Number Of Beneficiaries Age Less65 | 96 |
| Number Of Beneficiaries Age 65 to 74 | 43 |
| Number Of Beneficiaries Age 75 to 84 | 41 |
| Number Of Beneficiaries Age Greater 84 | 14 |
| Number Of Female Beneficiaries | 118 |
| Number Of Male Beneficiaries | 76 |
| Number Of Non Hispanic White Beneficiaries | 180 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| 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 | 100 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 94 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 41 |
| Percent Of With Hypertension | 42 |
| Percent Of With Ischemic Heart Disease | 16 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 27 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1374 |