| National Provider Identifier [NPI]: | 1427090133 |
| Last Name Of The Provider | PHELAN |
| First Name Of The Provider | GREGORY |
| 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 | 4801 W 81ST ST |
| Street Address 2 Of The Provider | SUITE 108 |
| City Of The Provider | BLOOMINGTON |
| Zip Code Of The Provider | 554371111 |
| 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 | 112 |
| Number Of Services | 2454 |
| Number Of Medicare Beneficiaries | 1237 |
| Total Submitted Charge Amount | 324258.96 |
| Total Medicare Allowed Amount | 96614.45 |
| Total Medicare Payment Amount | 73026.1 |
| Total Medicare Standardized Payment Amount | 76175.54 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 621 |
| Number Of Medicare Beneficiaries With Drug Services | 26 |
| Total Drug Submitted ChargeAmount | 875.46 |
| Total Drug Medicare AllowedAmount | 736.38 |
| Total Drug Medicare PaymentAmount | 567.91 |
| Total Drug Medicare Standardized Payment Amount | 567.91 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 110 |
| Number Of Medical Services | 1833 |
| Number Of Medicare Beneficiaries With Medical Services | 1237 |
| Total Medical Submitted Charge Amount | 323383.5 |
| Total Medical Medicare Allowed Amount | 95878.07 |
| Total Medical Medicare Payment Amount | 72458.19 |
| Total Medical Medicare Standardized Payment Amount | 75607.63 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 384 |
| Number Of Beneficiaries Age 65 to 74 | 291 |
| Number Of Beneficiaries Age 75 to 84 | 353 |
| Number Of Beneficiaries Age Greater 84 | 209 |
| Number Of Female Beneficiaries | 740 |
| Number Of Male Beneficiaries | 497 |
| Number Of Non Hispanic White Beneficiaries | 1142 |
| Number Of Black or African American Beneficiaries | 37 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 22 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 17 |
| Number Of Beneficiaries With Medicare Only Entitlement | 808 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 429 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 38 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 12 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.6688 |