| National Provider Identifier [NPI]: | 1780613075 |
| Last Name Of The Provider | EXCONDE |
| First Name Of The Provider | RUPERT |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2828 CHICAGO AVE SOUTH |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | MINNEAPOLIS |
| Zip Code Of The Provider | 554071320 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Neurology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 53 |
| Number Of Services | 10779 |
| Number Of Medicare Beneficiaries | 373 |
| Total Submitted Charge Amount | 635234 |
| Total Medicare Allowed Amount | 319263.58 |
| Total Medicare Payment Amount | 242812.13 |
| Total Medicare Standardized Payment Amount | 243996.02 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 15 |
| Number Of Drug Services | 10029 |
| Number Of Medicare Beneficiaries With Drug Services | 29 |
| Total Drug Submitted ChargeAmount | 351217 |
| Total Drug Medicare AllowedAmount | 203331.5 |
| Total Drug Medicare PaymentAmount | 158694.05 |
| Total Drug Medicare Standardized Payment Amount | 158694.05 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 38 |
| Number Of Medical Services | 750 |
| Number Of Medicare Beneficiaries With Medical Services | 373 |
| Total Medical Submitted Charge Amount | 284017 |
| Total Medical Medicare Allowed Amount | 115932.08 |
| Total Medical Medicare Payment Amount | 84118.08 |
| Total Medical Medicare Standardized Payment Amount | 85301.97 |
| Average Age Of Beneficiaries | 56 |
| Number Of Beneficiaries Age Less65 | 230 |
| Number Of Beneficiaries Age 65 to 74 | 66 |
| Number Of Beneficiaries Age 75 to 84 | 53 |
| Number Of Beneficiaries Age Greater 84 | 24 |
| Number Of Female Beneficiaries | 230 |
| Number Of Male Beneficiaries | 143 |
| Number Of Non Hispanic White Beneficiaries | 318 |
| Number Of Black or African American Beneficiaries | 29 |
| Number Of AsianPacific Islander Beneficiaries | 11 |
| 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 | 164 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 209 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 18 |
| Percent Of With Hyperlipidemia | 35 |
| Percent Of With Hypertension | 40 |
| Percent Of With Ischemic Heart Disease | 18 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 21 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 16 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.3922 |