| National Provider Identifier [NPI]: | 1518124239 |
| Last Name Of The Provider | HAMERNICK |
| First Name Of The Provider | HEATHER |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1400 1ST ST NE |
| Street Address 2 Of The Provider | |
| City Of The Provider | NEW PRAGUE |
| Zip Code Of The Provider | 560712215 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 66 |
| Number Of Services | 590 |
| Number Of Medicare Beneficiaries | 111 |
| Total Submitted Charge Amount | 49063 |
| Total Medicare Allowed Amount | 31127.28 |
| Total Medicare Payment Amount | 22847.13 |
| Total Medicare Standardized Payment Amount | 23407.75 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 75 |
| Number Of Medicare Beneficiaries With Drug Services | 38 |
| Total Drug Submitted ChargeAmount | 3552 |
| Total Drug Medicare AllowedAmount | 3148.02 |
| Total Drug Medicare PaymentAmount | 3063.84 |
| Total Drug Medicare Standardized Payment Amount | 3063.84 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 56 |
| Number Of Medical Services | 515 |
| Number Of Medicare Beneficiaries With Medical Services | 111 |
| Total Medical Submitted Charge Amount | 45511 |
| Total Medical Medicare Allowed Amount | 27979.26 |
| Total Medical Medicare Payment Amount | 19783.29 |
| Total Medical Medicare Standardized Payment Amount | 20343.91 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 26 |
| Number Of Beneficiaries Age 65 to 74 | 29 |
| Number Of Beneficiaries Age 75 to 84 | 40 |
| Number Of Beneficiaries Age Greater 84 | 16 |
| Number Of Female Beneficiaries | 81 |
| Number Of Male Beneficiaries | 30 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | 86 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 25 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 19 |
| Percent Of With Hyperlipidemia | 41 |
| Percent Of With Hypertension | 60 |
| Percent Of With Ischemic Heart Disease | 21 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 13 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0615 |