| National Provider Identifier [NPI]: | 1073515466 |
| Last Name Of The Provider | OBERSTAR |
| First Name Of The Provider | JENNIFER |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7373 FRANCE AVE S |
| Street Address 2 Of The Provider | 202 CENTENNIAL LAKES MEDICAL CENTER |
| City Of The Provider | EDINA |
| Zip Code Of The Provider | 554354534 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 72 |
| Number Of Services | 757 |
| Number Of Medicare Beneficiaries | 180 |
| Total Submitted Charge Amount | 100672 |
| Total Medicare Allowed Amount | 39319.15 |
| Total Medicare Payment Amount | 28686.37 |
| Total Medicare Standardized Payment Amount | 29388.28 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 69 |
| Number Of Medicare Beneficiaries With Drug Services | 31 |
| Total Drug Submitted ChargeAmount | 2873 |
| Total Drug Medicare AllowedAmount | 1339.98 |
| Total Drug Medicare PaymentAmount | 1195.14 |
| Total Drug Medicare Standardized Payment Amount | 1195.14 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 63 |
| Number Of Medical Services | 688 |
| Number Of Medicare Beneficiaries With Medical Services | 180 |
| Total Medical Submitted Charge Amount | 97799 |
| Total Medical Medicare Allowed Amount | 37979.17 |
| Total Medical Medicare Payment Amount | 27491.23 |
| Total Medical Medicare Standardized Payment Amount | 28193.14 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 45 |
| Number Of Beneficiaries Age 65 to 74 | 67 |
| Number Of Beneficiaries Age 75 to 84 | 39 |
| Number Of Beneficiaries Age Greater 84 | 29 |
| Number Of Female Beneficiaries | 117 |
| Number Of Male Beneficiaries | 63 |
| Number Of Non Hispanic White Beneficiaries | 158 |
| 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 | 123 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 57 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.5721 |