| National Provider Identifier [NPI]: | 1649495037 |
| Last Name Of The Provider | TROEDSON |
| First Name Of The Provider | ARTHUR |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1101 LINDEN LN |
| Street Address 2 Of The Provider | MINNESOTA CORRECTIONAL FACILITY FARIBAULT HEALTH SVCS |
| City Of The Provider | FARIBAULT |
| Zip Code Of The Provider | 550216400 |
| 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 | 78 |
| Number Of Services | 463 |
| Number Of Medicare Beneficiaries | 151 |
| Total Submitted Charge Amount | 42634.41 |
| Total Medicare Allowed Amount | 19717.79 |
| Total Medicare Payment Amount | 14966.8 |
| Total Medicare Standardized Payment Amount | 15235.83 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 20 |
| Number Of Medicare Beneficiaries With Drug Services | 14 |
| Total Drug Submitted ChargeAmount | 557 |
| Total Drug Medicare AllowedAmount | 399.75 |
| Total Drug Medicare PaymentAmount | 389.65 |
| Total Drug Medicare Standardized Payment Amount | 389.65 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 69 |
| Number Of Medical Services | 443 |
| Number Of Medicare Beneficiaries With Medical Services | 150 |
| Total Medical Submitted Charge Amount | 42077.41 |
| Total Medical Medicare Allowed Amount | 19318.04 |
| Total Medical Medicare Payment Amount | 14577.15 |
| Total Medical Medicare Standardized Payment Amount | 14846.18 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 44 |
| Number Of Beneficiaries Age 65 to 74 | 49 |
| Number Of Beneficiaries Age 75 to 84 | 39 |
| Number Of Beneficiaries Age Greater 84 | 19 |
| Number Of Female Beneficiaries | 88 |
| Number Of Male Beneficiaries | 63 |
| Number Of Non Hispanic White Beneficiaries | 139 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 110 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 41 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 16 |
| Percent Of With Hyperlipidemia | 34 |
| Percent Of With Hypertension | 43 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0943 |