| National Provider Identifier [NPI]: | 1982653978 |
| Last Name Of The Provider | UGARTE |
| First Name Of The Provider | ROLAND |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6525 FRANCE AVE S |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | EDINA |
| Zip Code Of The Provider | 554352148 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 79 |
| Number Of Services | 4286.5 |
| Number Of Medicare Beneficiaries | 451 |
| Total Submitted Charge Amount | 567155 |
| Total Medicare Allowed Amount | 216665.3 |
| Total Medicare Payment Amount | 159060.11 |
| Total Medicare Standardized Payment Amount | 164285.42 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 1687.5 |
| Number Of Medicare Beneficiaries With Drug Services | 65 |
| Total Drug Submitted ChargeAmount | 147615 |
| Total Drug Medicare AllowedAmount | 49762.07 |
| Total Drug Medicare PaymentAmount | 36601.94 |
| Total Drug Medicare Standardized Payment Amount | 36601.94 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 71 |
| Number Of Medical Services | 2599 |
| Number Of Medicare Beneficiaries With Medical Services | 451 |
| Total Medical Submitted Charge Amount | 419540 |
| Total Medical Medicare Allowed Amount | 166903.23 |
| Total Medical Medicare Payment Amount | 122458.17 |
| Total Medical Medicare Standardized Payment Amount | 127683.48 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 35 |
| Number Of Beneficiaries Age 65 to 74 | 147 |
| Number Of Beneficiaries Age 75 to 84 | 177 |
| Number Of Beneficiaries Age Greater 84 | 92 |
| Number Of Female Beneficiaries | 113 |
| Number Of Male Beneficiaries | 338 |
| Number Of Non Hispanic White Beneficiaries | 424 |
| 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 | 413 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 38 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 28 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 55 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 30 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0818 |