| National Provider Identifier [NPI]: | 1639145543 |
| Last Name Of The Provider | WARREN |
| First Name Of The Provider | JAMES |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 401 PHALEN BLVD - MAIL STOP 41103F |
| Street Address 2 Of The Provider | HEALTHPARTNERS SPECIALTY CENTER 401 |
| City Of The Provider | ST. PAUL |
| Zip Code Of The Provider | 551305302 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 67 |
| Number Of Services | 1460 |
| Number Of Medicare Beneficiaries | 251 |
| Total Submitted Charge Amount | 167488 |
| Total Medicare Allowed Amount | 63947.74 |
| Total Medicare Payment Amount | 47559.37 |
| Total Medicare Standardized Payment Amount | 48972.55 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 599 |
| Number Of Medicare Beneficiaries With Drug Services | 48 |
| Total Drug Submitted ChargeAmount | 7736 |
| Total Drug Medicare AllowedAmount | 4190.05 |
| Total Drug Medicare PaymentAmount | 3323.61 |
| Total Drug Medicare Standardized Payment Amount | 3323.61 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 56 |
| Number Of Medical Services | 861 |
| Number Of Medicare Beneficiaries With Medical Services | 251 |
| Total Medical Submitted Charge Amount | 159752 |
| Total Medical Medicare Allowed Amount | 59757.69 |
| Total Medical Medicare Payment Amount | 44235.76 |
| Total Medical Medicare Standardized Payment Amount | 45648.94 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 82 |
| Number Of Beneficiaries Age 65 to 74 | 57 |
| Number Of Beneficiaries Age 75 to 84 | 57 |
| Number Of Beneficiaries Age Greater 84 | 55 |
| Number Of Female Beneficiaries | 113 |
| Number Of Male Beneficiaries | 138 |
| Number Of Non Hispanic White Beneficiaries | 197 |
| Number Of Black or African American Beneficiaries | 38 |
| 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 | 140 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 111 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 22 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 34 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 17 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.7679 |