| National Provider Identifier [NPI]: | 1235493677 |
| Last Name Of The Provider | PECK |
| First Name Of The Provider | ADINA |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | DNP, RN, CNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3931 LOUISIANA AVE S |
| Street Address 2 Of The Provider | |
| City Of The Provider | SAINT LOUIS PARK |
| Zip Code Of The Provider | 554264375 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 93 |
| Number Of Services | 18720 |
| Number Of Medicare Beneficiaries | 133 |
| Total Submitted Charge Amount | 724164 |
| Total Medicare Allowed Amount | 285844.68 |
| Total Medicare Payment Amount | 223515.9 |
| Total Medicare Standardized Payment Amount | 228534.82 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 58 |
| Number Of Drug Services | 17961 |
| Number Of Medicare Beneficiaries With Drug Services | 86 |
| Total Drug Submitted ChargeAmount | 603122 |
| Total Drug Medicare AllowedAmount | 242120.55 |
| Total Drug Medicare PaymentAmount | 189517.71 |
| Total Drug Medicare Standardized Payment Amount | 189517.71 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 35 |
| Number Of Medical Services | 759 |
| Number Of Medicare Beneficiaries With Medical Services | 132 |
| Total Medical Submitted Charge Amount | 121042 |
| Total Medical Medicare Allowed Amount | 43724.13 |
| Total Medical Medicare Payment Amount | 33998.19 |
| Total Medical Medicare Standardized Payment Amount | 39017.11 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 19 |
| Number Of Beneficiaries Age 65 to 74 | 51 |
| Number Of Beneficiaries Age 75 to 84 | 44 |
| Number Of Beneficiaries Age Greater 84 | 19 |
| Number Of Female Beneficiaries | 78 |
| Number Of Male Beneficiaries | 55 |
| Number Of Non Hispanic White Beneficiaries | 120 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 0 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 116 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 17 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | 56 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 39 |
| Percent Of With Hypertension | 53 |
| Percent Of With Ischemic Heart Disease | 21 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 2.2637 |