| National Provider Identifier [NPI]: | 1205897998 |
| Last Name Of The Provider | MACDONALD |
| First Name Of The Provider | ANITA |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2635 UNIVERSITY AVE STE 160 |
| Street Address 2 Of The Provider | MAIL STOP 13901B |
| City Of The Provider | SAINT PAUL |
| Zip Code Of The Provider | 551141271 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 59 |
| Number Of Services | 490 |
| Number Of Medicare Beneficiaries | 103 |
| Total Submitted Charge Amount | 70736 |
| Total Medicare Allowed Amount | 26190.18 |
| Total Medicare Payment Amount | 20671.69 |
| Total Medicare Standardized Payment Amount | 21066.69 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 56 |
| Number Of Medicare Beneficiaries With Drug Services | 26 |
| Total Drug Submitted ChargeAmount | 2183 |
| Total Drug Medicare AllowedAmount | 1377.92 |
| Total Drug Medicare PaymentAmount | 1339.91 |
| Total Drug Medicare Standardized Payment Amount | 1339.91 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 51 |
| Number Of Medical Services | 434 |
| Number Of Medicare Beneficiaries With Medical Services | 103 |
| Total Medical Submitted Charge Amount | 68553 |
| Total Medical Medicare Allowed Amount | 24812.26 |
| Total Medical Medicare Payment Amount | 19331.78 |
| Total Medical Medicare Standardized Payment Amount | 19726.78 |
| Average Age Of Beneficiaries | 62 |
| Number Of Beneficiaries Age Less65 | 51 |
| Number Of Beneficiaries Age 65 to 74 | 31 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 85 |
| Number Of Male Beneficiaries | 18 |
| Number Of Non Hispanic White Beneficiaries | 69 |
| 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 | 47 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 56 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 44 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 39 |
| Percent Of With Hypertension | 60 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 14 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.5898 |