| National Provider Identifier [NPI]: | 1265453740 |
| Last Name Of The Provider | KNUTSON |
| First Name Of The Provider | MARK |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | P.A. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6070 S FORT APACHE ROAD |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | LAS VEGAS |
| Zip Code Of The Provider | 891485585 |
| State Code Of The Provider | NV |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 9 |
| Number Of Services | 2057 |
| Number Of Medicare Beneficiaries | 363 |
| Total Submitted Charge Amount | 383684.16 |
| Total Medicare Allowed Amount | 133251.33 |
| Total Medicare Payment Amount | 95004.24 |
| Total Medicare Standardized Payment Amount | 111079.15 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 30 |
| Number Of Medicare Beneficiaries With Drug Services | 22 |
| Total Drug Submitted ChargeAmount | 1782.6 |
| Total Drug Medicare AllowedAmount | 4.15 |
| Total Drug Medicare PaymentAmount | 3.24 |
| Total Drug Medicare Standardized Payment Amount | 3.24 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 8 |
| Number Of Medical Services | 2027 |
| Number Of Medicare Beneficiaries With Medical Services | 363 |
| Total Medical Submitted Charge Amount | 381901.56 |
| Total Medical Medicare Allowed Amount | 133247.18 |
| Total Medical Medicare Payment Amount | 95001 |
| Total Medical Medicare Standardized Payment Amount | 111075.91 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 116 |
| Number Of Beneficiaries Age 65 to 74 | 149 |
| Number Of Beneficiaries Age 75 to 84 | 72 |
| Number Of Beneficiaries Age Greater 84 | 26 |
| Number Of Female Beneficiaries | 227 |
| Number Of Male Beneficiaries | 136 |
| Number Of Non Hispanic White Beneficiaries | 302 |
| Number Of Black or African American Beneficiaries | 21 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 25 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 292 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 71 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 72 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.4248 |