| National Provider Identifier [NPI]: | 1356328777 |
| Last Name Of The Provider | SIMPSON |
| First Name Of The Provider | KURT |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6500 EXCELSIOR BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | ST LOUIS PARK |
| Zip Code Of The Provider | 554264702 |
| 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 | 173 |
| Number Of Services | 5824 |
| Number Of Medicare Beneficiaries | 846 |
| Total Submitted Charge Amount | 344118.05 |
| Total Medicare Allowed Amount | 117842.35 |
| Total Medicare Payment Amount | 89469.34 |
| Total Medicare Standardized Payment Amount | 95083.27 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 4350 |
| Number Of Medicare Beneficiaries With Drug Services | 48 |
| Total Drug Submitted ChargeAmount | 1081.25 |
| Total Drug Medicare AllowedAmount | 784.58 |
| Total Drug Medicare PaymentAmount | 587.44 |
| Total Drug Medicare Standardized Payment Amount | 587.44 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 172 |
| Number Of Medical Services | 1474 |
| Number Of Medicare Beneficiaries With Medical Services | 845 |
| Total Medical Submitted Charge Amount | 343036.8 |
| Total Medical Medicare Allowed Amount | 117057.77 |
| Total Medical Medicare Payment Amount | 88881.9 |
| Total Medical Medicare Standardized Payment Amount | 94495.83 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 210 |
| Number Of Beneficiaries Age 65 to 74 | 244 |
| Number Of Beneficiaries Age 75 to 84 | 229 |
| Number Of Beneficiaries Age Greater 84 | 163 |
| Number Of Female Beneficiaries | 492 |
| Number Of Male Beneficiaries | 354 |
| Number Of Non Hispanic White Beneficiaries | 735 |
| Number Of Black or African American Beneficiaries | 61 |
| Number Of AsianPacific Islander Beneficiaries | 22 |
| 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 | 623 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 223 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.9907 |