| National Provider Identifier [NPI]: | 1669659330 |
| Last Name Of The Provider | BORMANN |
| First Name Of The Provider | ALISON |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1221 W LAKE ST STE 201 |
| Street Address 2 Of The Provider | |
| City Of The Provider | MINNEAPOLIS |
| Zip Code Of The Provider | 554083565 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Infectious Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 39 |
| Number Of Services | 502 |
| Number Of Medicare Beneficiaries | 82 |
| Total Submitted Charge Amount | 46332 |
| Total Medicare Allowed Amount | 20315.91 |
| Total Medicare Payment Amount | 14385.3 |
| Total Medicare Standardized Payment Amount | 14950.25 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 196 |
| Number Of Medicare Beneficiaries With Drug Services | 24 |
| Total Drug Submitted ChargeAmount | 2611 |
| Total Drug Medicare AllowedAmount | 1205.17 |
| Total Drug Medicare PaymentAmount | 1150.84 |
| Total Drug Medicare Standardized Payment Amount | 1150.84 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 28 |
| Number Of Medical Services | 306 |
| Number Of Medicare Beneficiaries With Medical Services | 82 |
| Total Medical Submitted Charge Amount | 43721 |
| Total Medical Medicare Allowed Amount | 19110.74 |
| Total Medical Medicare Payment Amount | 13234.46 |
| Total Medical Medicare Standardized Payment Amount | 13799.41 |
| Average Age Of Beneficiaries | 58 |
| Number Of Beneficiaries Age Less65 | 48 |
| Number Of Beneficiaries Age 65 to 74 | |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 36 |
| Number Of Male Beneficiaries | 46 |
| Number Of Non Hispanic White Beneficiaries | 60 |
| 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 | 35 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 47 |
| 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 | 15 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 43 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 28 |
| Percent Of With Hypertension | 50 |
| Percent Of With Ischemic Heart Disease | 18 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 29 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.9514 |