| National Provider Identifier [NPI]: | 1417951443 |
| Last Name Of The Provider | DORN |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2828 CHICAGO AVE |
| Street Address 2 Of The Provider | STE 200 |
| City Of The Provider | MINNEAPOLIS |
| Zip Code Of The Provider | 554071544 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Neurology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 41 |
| Number Of Services | 3574 |
| Number Of Medicare Beneficiaries | 191 |
| Total Submitted Charge Amount | 279440 |
| Total Medicare Allowed Amount | 126181.35 |
| Total Medicare Payment Amount | 96242.5 |
| Total Medicare Standardized Payment Amount | 97225.26 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 15 |
| Number Of Drug Services | 3121 |
| Number Of Medicare Beneficiaries With Drug Services | 18 |
| Total Drug Submitted ChargeAmount | 156205 |
| Total Drug Medicare AllowedAmount | 81300.37 |
| Total Drug Medicare PaymentAmount | 63612.35 |
| Total Drug Medicare Standardized Payment Amount | 63612.35 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 26 |
| Number Of Medical Services | 453 |
| Number Of Medicare Beneficiaries With Medical Services | 191 |
| Total Medical Submitted Charge Amount | 123235 |
| Total Medical Medicare Allowed Amount | 44880.98 |
| Total Medical Medicare Payment Amount | 32630.15 |
| Total Medical Medicare Standardized Payment Amount | 33612.91 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 66 |
| Number Of Beneficiaries Age 65 to 74 | 46 |
| Number Of Beneficiaries Age 75 to 84 | 53 |
| Number Of Beneficiaries Age Greater 84 | 26 |
| Number Of Female Beneficiaries | 108 |
| Number Of Male Beneficiaries | 83 |
| Number Of Non Hispanic White Beneficiaries | 179 |
| 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 | 132 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 59 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 57 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 15 |
| Percent Of With Stroke | 21 |
| Average HCC Risk Score Of Beneficiaries | 1.5341 |