| National Provider Identifier [NPI]: | 1619114048 |
| Last Name Of The Provider | RASMUSSON |
| First Name Of The Provider | GRETCHEN |
| Middle Initial Of The Provider | R |
| 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 STE 100 |
| Street Address 2 Of The Provider | |
| City Of The Provider | EDINA |
| Zip Code Of The Provider | 554392529 |
| 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 | 34 |
| Number Of Services | 438 |
| Number Of Medicare Beneficiaries | 178 |
| Total Submitted Charge Amount | 94150 |
| Total Medicare Allowed Amount | 39276.09 |
| Total Medicare Payment Amount | 30109.41 |
| Total Medicare Standardized Payment Amount | 30775.1 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 37 |
| Number Of Medicare Beneficiaries With Drug Services | 34 |
| Total Drug Submitted ChargeAmount | 2085 |
| Total Drug Medicare AllowedAmount | 1273.02 |
| Total Drug Medicare PaymentAmount | 1242.77 |
| Total Drug Medicare Standardized Payment Amount | 1242.77 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 27 |
| Number Of Medical Services | 401 |
| Number Of Medicare Beneficiaries With Medical Services | 178 |
| Total Medical Submitted Charge Amount | 92065 |
| Total Medical Medicare Allowed Amount | 38003.07 |
| Total Medical Medicare Payment Amount | 28866.64 |
| Total Medical Medicare Standardized Payment Amount | 29532.33 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 13 |
| Number Of Beneficiaries Age 65 to 74 | 61 |
| Number Of Beneficiaries Age 75 to 84 | 69 |
| Number Of Beneficiaries Age Greater 84 | 35 |
| Number Of Female Beneficiaries | 128 |
| Number Of Male Beneficiaries | 50 |
| Number Of Non Hispanic White Beneficiaries | 167 |
| 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 | 17 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 20 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 20 |
| Percent Of With Hyperlipidemia | 41 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.2506 |