| National Provider Identifier [NPI]: | 1043446131 |
| Last Name Of The Provider | ANDERSEN |
| First Name Of The Provider | ROBERT |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | D.P.M. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5656 S POWER RD |
| Street Address 2 Of The Provider | #124 |
| City Of The Provider | GILBERT |
| Zip Code Of The Provider | 852958487 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 42 |
| Number Of Services | 1163 |
| Number Of Medicare Beneficiaries | 179 |
| Total Submitted Charge Amount | 138159 |
| Total Medicare Allowed Amount | 65344.87 |
| Total Medicare Payment Amount | 47998.48 |
| Total Medicare Standardized Payment Amount | 48463.36 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 201 |
| Number Of Medicare Beneficiaries With Drug Services | 24 |
| Total Drug Submitted ChargeAmount | 2010 |
| Total Drug Medicare AllowedAmount | 139.14 |
| Total Drug Medicare PaymentAmount | 102.96 |
| Total Drug Medicare Standardized Payment Amount | 102.96 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 40 |
| Number Of Medical Services | 962 |
| Number Of Medicare Beneficiaries With Medical Services | 179 |
| Total Medical Submitted Charge Amount | 136149 |
| Total Medical Medicare Allowed Amount | 65205.73 |
| Total Medical Medicare Payment Amount | 47895.52 |
| Total Medical Medicare Standardized Payment Amount | 48360.4 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 12 |
| Number Of Beneficiaries Age 65 to 74 | 97 |
| Number Of Beneficiaries Age 75 to 84 | 47 |
| Number Of Beneficiaries Age Greater 84 | 23 |
| Number Of Female Beneficiaries | 101 |
| Number Of Male Beneficiaries | 78 |
| Number Of Non Hispanic White Beneficiaries | 158 |
| Number Of Black or African American Beneficiaries | |
| 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 | 166 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 13 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.2306 |