| National Provider Identifier [NPI]: | 1982822540 |
| Last Name Of The Provider | PENN |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2200 NW 26TH ST |
| Street Address 2 Of The Provider | MAYO CLINIC HEALTH SYSTEM |
| City Of The Provider | OWATONNA |
| Zip Code Of The Provider | 550605503 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 142 |
| Number Of Services | 3276 |
| Number Of Medicare Beneficiaries | 994 |
| Total Submitted Charge Amount | 1155251.52 |
| Total Medicare Allowed Amount | 147981.13 |
| Total Medicare Payment Amount | 114781.6 |
| Total Medicare Standardized Payment Amount | 115547.27 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 1253 |
| Number Of Medicare Beneficiaries With Drug Services | 92 |
| Total Drug Submitted ChargeAmount | 9436.2 |
| Total Drug Medicare AllowedAmount | 2413.78 |
| Total Drug Medicare PaymentAmount | 1786.55 |
| Total Drug Medicare Standardized Payment Amount | 1786.55 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 138 |
| Number Of Medical Services | 2023 |
| Number Of Medicare Beneficiaries With Medical Services | 992 |
| Total Medical Submitted Charge Amount | 1145815.32 |
| Total Medical Medicare Allowed Amount | 145567.35 |
| Total Medical Medicare Payment Amount | 112995.05 |
| Total Medical Medicare Standardized Payment Amount | 113760.72 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 222 |
| Number Of Beneficiaries Age 65 to 74 | 271 |
| Number Of Beneficiaries Age 75 to 84 | 274 |
| Number Of Beneficiaries Age Greater 84 | 227 |
| Number Of Female Beneficiaries | 647 |
| Number Of Male Beneficiaries | 347 |
| Number Of Non Hispanic White Beneficiaries | 943 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 21 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 16 |
| Number Of Beneficiaries With Medicare Only Entitlement | 743 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 251 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 38 |
| Percent Of With Hypertension | 60 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 28 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.2312 |