| National Provider Identifier [NPI]: | 1619956893 |
| Last Name Of The Provider | LUNDSTROM |
| First Name Of The Provider | CARL |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 200 1ST ST SW |
| Street Address 2 Of The Provider | |
| City Of The Provider | ROCHESTER |
| Zip Code Of The Provider | 559050001 |
| 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 | 25 |
| Number Of Services | 1776 |
| Number Of Medicare Beneficiaries | 819 |
| Total Submitted Charge Amount | 108710.91 |
| Total Medicare Allowed Amount | 99976.89 |
| Total Medicare Payment Amount | 87195.35 |
| Total Medicare Standardized Payment Amount | 90496.89 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 704 |
| Number Of Medicare Beneficiaries With Drug Services | 668 |
| Total Drug Submitted ChargeAmount | 46652.24 |
| Total Drug Medicare AllowedAmount | 45241.79 |
| Total Drug Medicare PaymentAmount | 42406.73 |
| Total Drug Medicare Standardized Payment Amount | 42406.73 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 19 |
| Number Of Medical Services | 1072 |
| Number Of Medicare Beneficiaries With Medical Services | 817 |
| Total Medical Submitted Charge Amount | 62058.67 |
| Total Medical Medicare Allowed Amount | 54735.1 |
| Total Medical Medicare Payment Amount | 44788.62 |
| Total Medical Medicare Standardized Payment Amount | 48090.16 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 90 |
| Number Of Beneficiaries Age 65 to 74 | 395 |
| Number Of Beneficiaries Age 75 to 84 | 275 |
| Number Of Beneficiaries Age Greater 84 | 59 |
| Number Of Female Beneficiaries | 416 |
| Number Of Male Beneficiaries | 403 |
| Number Of Non Hispanic White Beneficiaries | 777 |
| Number Of Black or African American Beneficiaries | 11 |
| 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 | 16 |
| Number Of Beneficiaries With Medicare Only Entitlement | 777 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 42 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 41 |
| Percent Of With Hypertension | 48 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 2 |
| Average HCC Risk Score Of Beneficiaries | 1.2448 |