| National Provider Identifier [NPI]: | 1699755462 |
| Last Name Of The Provider | TUCKER |
| First Name Of The Provider | ROSS |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1216 RYANS RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | WORTHINGTON |
| Zip Code Of The Provider | 561871722 |
| 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 | 142 |
| Number Of Services | 6895 |
| Number Of Medicare Beneficiaries | 265 |
| Total Submitted Charge Amount | 192107.26 |
| Total Medicare Allowed Amount | 187127.89 |
| Total Medicare Payment Amount | 145175.41 |
| Total Medicare Standardized Payment Amount | 146241.51 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 28 |
| Number Of Drug Services | 3116 |
| Number Of Medicare Beneficiaries With Drug Services | 95 |
| Total Drug Submitted ChargeAmount | 100853.7 |
| Total Drug Medicare AllowedAmount | 100387.21 |
| Total Drug Medicare PaymentAmount | 79091.12 |
| Total Drug Medicare Standardized Payment Amount | 79091.12 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 114 |
| Number Of Medical Services | 3779 |
| Number Of Medicare Beneficiaries With Medical Services | 265 |
| Total Medical Submitted Charge Amount | 91253.56 |
| Total Medical Medicare Allowed Amount | 86740.68 |
| Total Medical Medicare Payment Amount | 66084.29 |
| Total Medical Medicare Standardized Payment Amount | 67150.39 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 28 |
| Number Of Beneficiaries Age 65 to 74 | 90 |
| Number Of Beneficiaries Age 75 to 84 | 93 |
| Number Of Beneficiaries Age Greater 84 | 54 |
| Number Of Female Beneficiaries | 137 |
| Number Of Male Beneficiaries | 128 |
| Number Of Non Hispanic White Beneficiaries | 247 |
| Number Of Black or African American Beneficiaries | 0 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 227 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 38 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 25 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1372 |