| National Provider Identifier [NPI]: | 1629037510 |
| Last Name Of The Provider | RODEL |
| First Name Of The Provider | DONNA |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 8100 W 78TH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | EDINA |
| Zip Code Of The Provider | 554392516 |
| 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 | 21 |
| Number Of Services | 782 |
| Number Of Medicare Beneficiaries | 202 |
| Total Submitted Charge Amount | 152005 |
| Total Medicare Allowed Amount | 70573.09 |
| Total Medicare Payment Amount | 54758.2 |
| Total Medicare Standardized Payment Amount | 55851.97 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 115 |
| Number Of Medicare Beneficiaries With Drug Services | 77 |
| Total Drug Submitted ChargeAmount | 16342 |
| Total Drug Medicare AllowedAmount | 8330.17 |
| Total Drug Medicare PaymentAmount | 7998.22 |
| Total Drug Medicare Standardized Payment Amount | 7998.22 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 15 |
| Number Of Medical Services | 667 |
| Number Of Medicare Beneficiaries With Medical Services | 200 |
| Total Medical Submitted Charge Amount | 135663 |
| Total Medical Medicare Allowed Amount | 62242.92 |
| Total Medical Medicare Payment Amount | 46759.98 |
| Total Medical Medicare Standardized Payment Amount | 47853.75 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 80 |
| Number Of Beneficiaries Age 75 to 84 | 80 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 159 |
| Number Of Male Beneficiaries | 43 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 7 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 14 |
| Percent Of With Hyperlipidemia | 35 |
| Percent Of With Hypertension | 57 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 28 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.995 |