| National Provider Identifier [NPI]: | 1992782882 |
| Last Name Of The Provider | TIERNEY |
| First Name Of The Provider | ROBERT |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3800 PARK NICOLLET BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | ST LOUIS PARK |
| Zip Code Of The Provider | 554162527 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Rheumatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 64 |
| Number Of Services | 16803 |
| Number Of Medicare Beneficiaries | 498 |
| Total Submitted Charge Amount | 764956.25 |
| Total Medicare Allowed Amount | 318465.42 |
| Total Medicare Payment Amount | 240787.04 |
| Total Medicare Standardized Payment Amount | 242184.8 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 22 |
| Number Of Drug Services | 15416 |
| Number Of Medicare Beneficiaries With Drug Services | 123 |
| Total Drug Submitted ChargeAmount | 546292 |
| Total Drug Medicare AllowedAmount | 229391.49 |
| Total Drug Medicare PaymentAmount | 175137.02 |
| Total Drug Medicare Standardized Payment Amount | 175137.02 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 42 |
| Number Of Medical Services | 1387 |
| Number Of Medicare Beneficiaries With Medical Services | 497 |
| Total Medical Submitted Charge Amount | 218664.25 |
| Total Medical Medicare Allowed Amount | 89073.93 |
| Total Medical Medicare Payment Amount | 65650.02 |
| Total Medical Medicare Standardized Payment Amount | 67047.78 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 84 |
| Number Of Beneficiaries Age 65 to 74 | 211 |
| Number Of Beneficiaries Age 75 to 84 | 144 |
| Number Of Beneficiaries Age Greater 84 | 59 |
| Number Of Female Beneficiaries | 390 |
| Number Of Male Beneficiaries | 108 |
| Number Of Non Hispanic White Beneficiaries | 454 |
| Number Of Black or African American Beneficiaries | 14 |
| 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 | 12 |
| Number Of Beneficiaries With Medicare Only Entitlement | 407 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 91 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 16 |
| Percent Of With Hyperlipidemia | 35 |
| Percent Of With Hypertension | 52 |
| Percent Of With Ischemic Heart Disease | 15 |
| Percent Of With Osteoporosis | 32 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 64 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.1879 |