| National Provider Identifier [NPI]: | 1639197502 |
| Last Name Of The Provider | SILAS |
| First Name Of The Provider | MOLLY |
| Middle Initial Of The Provider | V |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7945 STONE CREEK DR. SUITE 130 |
| Street Address 2 Of The Provider | STONE CREEK PSYCHIATRY |
| City Of The Provider | CHANHASSEN |
| Zip Code Of The Provider | 55317 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Psychiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 11 |
| Number Of Services | 1232 |
| Number Of Medicare Beneficiaries | 216 |
| Total Submitted Charge Amount | 140339.9 |
| Total Medicare Allowed Amount | 70038.75 |
| Total Medicare Payment Amount | 48629.74 |
| Total Medicare Standardized Payment Amount | 52732.85 |
| Drug Suppress Indicator | * |
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| Medical SuppressIndicator | # |
| Number Of HCPCS Associated With MedicalServices | |
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| Number Of Medicare Beneficiaries With Medical Services | |
| Total Medical Submitted Charge Amount | |
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| Average Age Of Beneficiaries | 55 |
| Number Of Beneficiaries Age Less65 | 163 |
| Number Of Beneficiaries Age 65 to 74 | |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 141 |
| Number Of Male Beneficiaries | 75 |
| Number Of Non Hispanic White Beneficiaries | 186 |
| Number Of Black or African American Beneficiaries | 11 |
| 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 | 72 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 144 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 6 |
| Percent Of With Chronic Kidney Disease | 11 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 71 |
| Percent Of With Diabetes | 19 |
| Percent Of With Hyperlipidemia | 28 |
| Percent Of With Hypertension | 30 |
| Percent Of With Ischemic Heart Disease | 7 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 21 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 38 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1154 |