| National Provider Identifier [NPI]: | 1538135843 |
| Last Name Of The Provider | ROSS |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 320 SOUTH SIBLEY AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | LITCHFIELD |
| Zip Code Of The Provider | 55355 |
| 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 | 113 |
| Number Of Services | 1666 |
| Number Of Medicare Beneficiaries | 316 |
| Total Submitted Charge Amount | 159073.74 |
| Total Medicare Allowed Amount | 55160.54 |
| Total Medicare Payment Amount | 41782.3 |
| Total Medicare Standardized Payment Amount | 43141.54 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 76 |
| Number Of Medicare Beneficiaries With Drug Services | 60 |
| Total Drug Submitted ChargeAmount | 2941.64 |
| Total Drug Medicare AllowedAmount | 1394.13 |
| Total Drug Medicare PaymentAmount | 1293.67 |
| Total Drug Medicare Standardized Payment Amount | 1293.67 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 104 |
| Number Of Medical Services | 1590 |
| Number Of Medicare Beneficiaries With Medical Services | 316 |
| Total Medical Submitted Charge Amount | 156132.1 |
| Total Medical Medicare Allowed Amount | 53766.41 |
| Total Medical Medicare Payment Amount | 40488.63 |
| Total Medical Medicare Standardized Payment Amount | 41847.87 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 82 |
| Number Of Beneficiaries Age 65 to 74 | 75 |
| Number Of Beneficiaries Age 75 to 84 | 90 |
| Number Of Beneficiaries Age Greater 84 | 69 |
| Number Of Female Beneficiaries | 138 |
| Number Of Male Beneficiaries | 178 |
| Number Of Non Hispanic White Beneficiaries | 305 |
| 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 | 216 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 100 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 40 |
| Percent Of With Hypertension | 54 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 23 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 16 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.3369 |