| National Provider Identifier [NPI]: | 1669563771 |
| Last Name Of The Provider | DENTCHEV |
| First Name Of The Provider | TODOR |
| Middle Initial Of The Provider | N |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1000 SOUTH COLUMBIA ROAD |
| Street Address 2 Of The Provider | |
| City Of The Provider | GRAND FORKS |
| Zip Code Of The Provider | 582066002 |
| State Code Of The Provider | ND |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 114 |
| Number Of Services | 8923 |
| Number Of Medicare Beneficiaries | 373 |
| Total Submitted Charge Amount | 742567.3 |
| Total Medicare Allowed Amount | 317246.35 |
| Total Medicare Payment Amount | 173456.56 |
| Total Medicare Standardized Payment Amount | 191701.21 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 34 |
| Number Of Drug Services | 6504 |
| Number Of Medicare Beneficiaries With Drug Services | 24 |
| Total Drug Submitted ChargeAmount | 317105.05 |
| Total Drug Medicare AllowedAmount | 102649.25 |
| Total Drug Medicare PaymentAmount | 23345.29 |
| Total Drug Medicare Standardized Payment Amount | 23345.29 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 80 |
| Number Of Medical Services | 2419 |
| Number Of Medicare Beneficiaries With Medical Services | 373 |
| Total Medical Submitted Charge Amount | 425462.25 |
| Total Medical Medicare Allowed Amount | 214597.1 |
| Total Medical Medicare Payment Amount | 150111.27 |
| Total Medical Medicare Standardized Payment Amount | 168355.92 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 43 |
| Number Of Beneficiaries Age 65 to 74 | 143 |
| Number Of Beneficiaries Age 75 to 84 | 130 |
| Number Of Beneficiaries Age Greater 84 | 57 |
| Number Of Female Beneficiaries | 212 |
| Number Of Male Beneficiaries | 161 |
| Number Of Non Hispanic White Beneficiaries | 355 |
| 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 | 330 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 43 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 51 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.9812 |