| National Provider Identifier [NPI]: | 1780664268 |
| Last Name Of The Provider | KNUDSEN |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 200 1ST ST SW |
| Street Address 2 Of The Provider | |
| City Of The Provider | ROCHESTER |
| Zip Code Of The Provider | 559050001 |
| 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 | 60 |
| Number Of Services | 16221 |
| Number Of Medicare Beneficiaries | 666 |
| Total Submitted Charge Amount | 201117.6 |
| Total Medicare Allowed Amount | 130891.31 |
| Total Medicare Payment Amount | 97985.29 |
| Total Medicare Standardized Payment Amount | 107794.28 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 15434 |
| Number Of Medicare Beneficiaries With Drug Services | 145 |
| Total Drug Submitted ChargeAmount | 6240.74 |
| Total Drug Medicare AllowedAmount | 4751.35 |
| Total Drug Medicare PaymentAmount | 3329.49 |
| Total Drug Medicare Standardized Payment Amount | 3329.49 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 55 |
| Number Of Medical Services | 787 |
| Number Of Medicare Beneficiaries With Medical Services | 666 |
| Total Medical Submitted Charge Amount | 194876.86 |
| Total Medical Medicare Allowed Amount | 126139.96 |
| Total Medical Medicare Payment Amount | 94655.8 |
| Total Medical Medicare Standardized Payment Amount | 104464.79 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 121 |
| Number Of Beneficiaries Age 65 to 74 | 277 |
| Number Of Beneficiaries Age 75 to 84 | 210 |
| Number Of Beneficiaries Age Greater 84 | 58 |
| Number Of Female Beneficiaries | 312 |
| Number Of Male Beneficiaries | 354 |
| Number Of Non Hispanic White Beneficiaries | 626 |
| 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 | 12 |
| Number Of Beneficiaries With Medicare Only Entitlement | 580 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 86 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 21 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.8138 |