| National Provider Identifier [NPI]: | 1063852085 |
| Last Name Of The Provider | MINADAKIS |
| First Name Of The Provider | DIMITRIOS |
| Middle Initial Of The Provider | N |
| Credentials Of The Provider | PA-C |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 251 COUNTY ROAD 120 |
| Street Address 2 Of The Provider | |
| City Of The Provider | SAINT CLOUD |
| Zip Code Of The Provider | 563034872 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 76 |
| Number Of Services | 372 |
| Number Of Medicare Beneficiaries | 118 |
| Total Submitted Charge Amount | 27449.19 |
| Total Medicare Allowed Amount | 12295.4 |
| Total Medicare Payment Amount | 8584.12 |
| Total Medicare Standardized Payment Amount | 10359.26 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 33 |
| Number Of Medicare Beneficiaries With Drug Services | 23 |
| Total Drug Submitted ChargeAmount | 749.82 |
| Total Drug Medicare AllowedAmount | 585.84 |
| Total Drug Medicare PaymentAmount | 505.36 |
| Total Drug Medicare Standardized Payment Amount | 505.36 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 69 |
| Number Of Medical Services | 339 |
| Number Of Medicare Beneficiaries With Medical Services | 118 |
| Total Medical Submitted Charge Amount | 26699.37 |
| Total Medical Medicare Allowed Amount | 11709.56 |
| Total Medical Medicare Payment Amount | 8078.76 |
| Total Medical Medicare Standardized Payment Amount | 9853.9 |
| Average Age Of Beneficiaries | 62 |
| Number Of Beneficiaries Age Less65 | 47 |
| Number Of Beneficiaries Age 65 to 74 | 40 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 78 |
| Number Of Male Beneficiaries | 40 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | 69 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 49 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 12 |
| Percent Of With Hyperlipidemia | 29 |
| Percent Of With Hypertension | 38 |
| Percent Of With Ischemic Heart Disease | 13 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 26 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8735 |