| National Provider Identifier [NPI]: | 1861697161 |
| Last Name Of The Provider | KEBEDE |
| First Name Of The Provider | ESAYAS |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | MD |
| 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 | 1075 |
| Number Of Medicare Beneficiaries | 700 |
| Total Submitted Charge Amount | 85142.32 |
| Total Medicare Allowed Amount | 75834.88 |
| Total Medicare Payment Amount | 61729.13 |
| Total Medicare Standardized Payment Amount | 65508.62 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 239 |
| Number Of Medicare Beneficiaries With Drug Services | 224 |
| Total Drug Submitted ChargeAmount | 22198.87 |
| Total Drug Medicare AllowedAmount | 21087.95 |
| Total Drug Medicare PaymentAmount | 19220.61 |
| Total Drug Medicare Standardized Payment Amount | 19220.61 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 19 |
| Number Of Medical Services | 836 |
| Number Of Medicare Beneficiaries With Medical Services | 698 |
| Total Medical Submitted Charge Amount | 62943.45 |
| Total Medical Medicare Allowed Amount | 54746.93 |
| Total Medical Medicare Payment Amount | 42508.52 |
| Total Medical Medicare Standardized Payment Amount | 46288.01 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 106 |
| Number Of Beneficiaries Age 65 to 74 | 348 |
| Number Of Beneficiaries Age 75 to 84 | 187 |
| Number Of Beneficiaries Age Greater 84 | 59 |
| Number Of Female Beneficiaries | 347 |
| Number Of Male Beneficiaries | 353 |
| Number Of Non Hispanic White Beneficiaries | 658 |
| 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 | 16 |
| Number Of Beneficiaries With Medicare Only Entitlement | 641 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 59 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 62 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.2815 |