| National Provider Identifier [NPI]: | 1396711628 |
| Last Name Of The Provider | MACKENZIE |
| First Name Of The Provider | KAREN |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2831 SNELLING AVE N |
| Street Address 2 Of The Provider | MAIL STOP 39601A |
| City Of The Provider | ROSEVILLE |
| Zip Code Of The Provider | 551132460 |
| 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 | 53 |
| Number Of Services | 1240 |
| Number Of Medicare Beneficiaries | 238 |
| Total Submitted Charge Amount | 133049 |
| Total Medicare Allowed Amount | 48339.13 |
| Total Medicare Payment Amount | 33269.48 |
| Total Medicare Standardized Payment Amount | 34008.67 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 111 |
| Number Of Medicare Beneficiaries With Drug Services | 70 |
| Total Drug Submitted ChargeAmount | 2634 |
| Total Drug Medicare AllowedAmount | 1810.35 |
| Total Drug Medicare PaymentAmount | 1642.88 |
| Total Drug Medicare Standardized Payment Amount | 1642.88 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 46 |
| Number Of Medical Services | 1129 |
| Number Of Medicare Beneficiaries With Medical Services | 238 |
| Total Medical Submitted Charge Amount | 130415 |
| Total Medical Medicare Allowed Amount | 46528.78 |
| Total Medical Medicare Payment Amount | 31626.6 |
| Total Medical Medicare Standardized Payment Amount | 32365.79 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 61 |
| Number Of Beneficiaries Age 65 to 74 | 78 |
| Number Of Beneficiaries Age 75 to 84 | 56 |
| Number Of Beneficiaries Age Greater 84 | 43 |
| Number Of Female Beneficiaries | 187 |
| Number Of Male Beneficiaries | 51 |
| Number Of Non Hispanic White Beneficiaries | 211 |
| 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 | 178 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 60 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 8 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 19 |
| Percent Of With Hyperlipidemia | 32 |
| Percent Of With Hypertension | 48 |
| Percent Of With Ischemic Heart Disease | 13 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 27 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0114 |