| National Provider Identifier [NPI]: | 1952444010 |
| Last Name Of The Provider | CALDWELL |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 400 EAST 3RD STREET |
| Street Address 2 Of The Provider | DULUTH CLINIC |
| City Of The Provider | DULUTH |
| Zip Code Of The Provider | 55805 |
| 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 | 180 |
| Number Of Services | 4248 |
| Number Of Medicare Beneficiaries | 2424 |
| Total Submitted Charge Amount | 619969 |
| Total Medicare Allowed Amount | 117745.17 |
| Total Medicare Payment Amount | 87727.02 |
| Total Medicare Standardized Payment Amount | 90755.89 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 345 |
| Number Of Medicare Beneficiaries With Drug Services | 12 |
| Total Drug Submitted ChargeAmount | 3195 |
| Total Drug Medicare AllowedAmount | 543.07 |
| Total Drug Medicare PaymentAmount | 391.95 |
| Total Drug Medicare Standardized Payment Amount | 391.95 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 176 |
| Number Of Medical Services | 3903 |
| Number Of Medicare Beneficiaries With Medical Services | 2423 |
| Total Medical Submitted Charge Amount | 616774 |
| Total Medical Medicare Allowed Amount | 117202.1 |
| Total Medical Medicare Payment Amount | 87335.07 |
| Total Medical Medicare Standardized Payment Amount | 90363.94 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 742 |
| Number Of Beneficiaries Age 65 to 74 | 781 |
| Number Of Beneficiaries Age 75 to 84 | 545 |
| Number Of Beneficiaries Age Greater 84 | 356 |
| Number Of Female Beneficiaries | 1297 |
| Number Of Male Beneficiaries | 1127 |
| Number Of Non Hispanic White Beneficiaries | 2223 |
| Number Of Black or African American Beneficiaries | 29 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 123 |
| Number Of Beneficiaries With Race Not Else where Classified | 28 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1519 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 905 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 14 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.5604 |