| National Provider Identifier [NPI]: | 1194765388 |
| Last Name Of The Provider | CALKWOOD |
| First Name Of The Provider | JONATHAN |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4225 GOLDEN VALLEY RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | GOLDEN VALLEY |
| Zip Code Of The Provider | 554224215 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Neurology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 51 |
| Number Of Services | 97211 |
| Number Of Medicare Beneficiaries | 264 |
| Total Submitted Charge Amount | 5678312.3 |
| Total Medicare Allowed Amount | 1556365.3 |
| Total Medicare Payment Amount | 1193246.08 |
| Total Medicare Standardized Payment Amount | 1222940.78 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 95394 |
| Number Of Medicare Beneficiaries With Drug Services | 64 |
| Total Drug Submitted ChargeAmount | 3590534.3 |
| Total Drug Medicare AllowedAmount | 1267138.73 |
| Total Drug Medicare PaymentAmount | 980436.5 |
| Total Drug Medicare Standardized Payment Amount | 980436.5 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 45 |
| Number Of Medical Services | 1817 |
| Number Of Medicare Beneficiaries With Medical Services | 264 |
| Total Medical Submitted Charge Amount | 2087778 |
| Total Medical Medicare Allowed Amount | 289226.57 |
| Total Medical Medicare Payment Amount | 212809.58 |
| Total Medical Medicare Standardized Payment Amount | 242504.28 |
| Average Age Of Beneficiaries | 57 |
| Number Of Beneficiaries Age Less65 | 193 |
| Number Of Beneficiaries Age 65 to 74 | 57 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 195 |
| Number Of Male Beneficiaries | 69 |
| Number Of Non Hispanic White Beneficiaries | 253 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 0 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 147 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 117 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 10 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 50 |
| Percent Of With Diabetes | 12 |
| Percent Of With Hyperlipidemia | 25 |
| Percent Of With Hypertension | 33 |
| Percent Of With Ischemic Heart Disease | 6 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 14 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.6112 |