| National Provider Identifier [NPI]: | 1437124872 |
| Last Name Of The Provider | GLAZEBROOK |
| First Name Of The Provider | KATRINA |
| Middle Initial Of The Provider | N |
| Credentials Of The Provider | MBCHB |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 200 1ST ST SW |
| Street Address 2 Of The Provider | |
| City Of The Provider | ROCHESTER |
| Zip Code Of The Provider | 559050001 |
| 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 | 118 |
| Number Of Services | 4671 |
| Number Of Medicare Beneficiaries | 1848 |
| Total Submitted Charge Amount | 197015.66 |
| Total Medicare Allowed Amount | 133010.28 |
| Total Medicare Payment Amount | 100253.76 |
| Total Medicare Standardized Payment Amount | 110287.78 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 997 |
| Number Of Medicare Beneficiaries With Drug Services | 80 |
| Total Drug Submitted ChargeAmount | 2818.39 |
| Total Drug Medicare AllowedAmount | 2288.72 |
| Total Drug Medicare PaymentAmount | 1575.11 |
| Total Drug Medicare Standardized Payment Amount | 1575.11 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 111 |
| Number Of Medical Services | 3674 |
| Number Of Medicare Beneficiaries With Medical Services | 1848 |
| Total Medical Submitted Charge Amount | 194197.27 |
| Total Medical Medicare Allowed Amount | 130721.56 |
| Total Medical Medicare Payment Amount | 98678.65 |
| Total Medical Medicare Standardized Payment Amount | 108712.67 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 313 |
| Number Of Beneficiaries Age 65 to 74 | 710 |
| Number Of Beneficiaries Age 75 to 84 | 580 |
| Number Of Beneficiaries Age Greater 84 | 245 |
| Number Of Female Beneficiaries | 1077 |
| Number Of Male Beneficiaries | 771 |
| Number Of Non Hispanic White Beneficiaries | 1750 |
| Number Of Black or African American Beneficiaries | 33 |
| Number Of AsianPacific Islander Beneficiaries | 19 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 22 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1580 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 268 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 55 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.4873 |