| National Provider Identifier [NPI]: | 1053343053 |
| Last Name Of The Provider | GAD |
| First Name Of The Provider | DINA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1221 W LAKE ST |
| Street Address 2 Of The Provider | STE 201 |
| City Of The Provider | MINNEAPOLIS |
| Zip Code Of The Provider | 554083397 |
| 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 | 42 |
| Number Of Services | 468 |
| Number Of Medicare Beneficiaries | 97 |
| Total Submitted Charge Amount | 58391 |
| Total Medicare Allowed Amount | 25581.72 |
| Total Medicare Payment Amount | 18403.16 |
| Total Medicare Standardized Payment Amount | 19176.45 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 36 |
| Number Of Medicare Beneficiaries With Drug Services | 29 |
| Total Drug Submitted ChargeAmount | 2555 |
| Total Drug Medicare AllowedAmount | 1199.55 |
| Total Drug Medicare PaymentAmount | 1156.14 |
| Total Drug Medicare Standardized Payment Amount | 1156.14 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 34 |
| Number Of Medical Services | 432 |
| Number Of Medicare Beneficiaries With Medical Services | 97 |
| Total Medical Submitted Charge Amount | 55836 |
| Total Medical Medicare Allowed Amount | 24382.17 |
| Total Medical Medicare Payment Amount | 17247.02 |
| Total Medical Medicare Standardized Payment Amount | 18020.31 |
| Average Age Of Beneficiaries | 59 |
| Number Of Beneficiaries Age Less65 | 58 |
| Number Of Beneficiaries Age 65 to 74 | 25 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 52 |
| Number Of Male Beneficiaries | 45 |
| Number Of Non Hispanic White Beneficiaries | 66 |
| Number Of Black or African American Beneficiaries | 20 |
| 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 | 43 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 54 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 26 |
| Percent Of With Hypertension | 43 |
| Percent Of With Ischemic Heart Disease | 14 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 25 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 16 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.4833 |