| National Provider Identifier [NPI]: | 1316928104 |
| Last Name Of The Provider | CALDWELL |
| First Name Of The Provider | KEVIN |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1240 MARSHALL ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | CRESCENT CITY |
| Zip Code Of The Provider | 955312217 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 38 |
| Number Of Services | 2289 |
| Number Of Medicare Beneficiaries | 279 |
| Total Submitted Charge Amount | 118463.32 |
| Total Medicare Allowed Amount | 117102.9 |
| Total Medicare Payment Amount | 85113.85 |
| Total Medicare Standardized Payment Amount | 83652.45 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 82 |
| Number Of Medicare Beneficiaries With Drug Services | 73 |
| Total Drug Submitted ChargeAmount | 1337.16 |
| Total Drug Medicare AllowedAmount | 1294.71 |
| Total Drug Medicare PaymentAmount | 1268.72 |
| Total Drug Medicare Standardized Payment Amount | 1268.72 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 35 |
| Number Of Medical Services | 2207 |
| Number Of Medicare Beneficiaries With Medical Services | 279 |
| Total Medical Submitted Charge Amount | 117126.16 |
| Total Medical Medicare Allowed Amount | 115808.19 |
| Total Medical Medicare Payment Amount | 83845.13 |
| Total Medical Medicare Standardized Payment Amount | 82383.73 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 190 |
| Number Of Beneficiaries Age 75 to 84 | 66 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 92 |
| Number Of Male Beneficiaries | 187 |
| Number Of Non Hispanic White Beneficiaries | 264 |
| Number Of Black or African American Beneficiaries | 0 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 7 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 32 |
| Percent Of With Hypertension | 47 |
| Percent Of With Ischemic Heart Disease | 20 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 21 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.6595 |