| National Provider Identifier [NPI]: | 1912985037 |
| Last Name Of The Provider | KNUTZEN |
| First Name Of The Provider | ANDERS |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 166 4TH ST E |
| Street Address 2 Of The Provider | |
| City Of The Provider | SAINT PAUL |
| Zip Code Of The Provider | 551011421 |
| 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 | 177 |
| Number Of Services | 8125 |
| Number Of Medicare Beneficiaries | 2884 |
| Total Submitted Charge Amount | 471305.68 |
| Total Medicare Allowed Amount | 158445.59 |
| Total Medicare Payment Amount | 124320.05 |
| Total Medicare Standardized Payment Amount | 128316.59 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 3356 |
| Number Of Medicare Beneficiaries With Drug Services | 32 |
| Total Drug Submitted ChargeAmount | 5177.5 |
| Total Drug Medicare AllowedAmount | 779.82 |
| Total Drug Medicare PaymentAmount | 611.35 |
| Total Drug Medicare Standardized Payment Amount | 611.35 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 173 |
| Number Of Medical Services | 4769 |
| Number Of Medicare Beneficiaries With Medical Services | 2884 |
| Total Medical Submitted Charge Amount | 466128.18 |
| Total Medical Medicare Allowed Amount | 157665.77 |
| Total Medical Medicare Payment Amount | 123708.7 |
| Total Medical Medicare Standardized Payment Amount | 127705.24 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 703 |
| Number Of Beneficiaries Age 65 to 74 | 997 |
| Number Of Beneficiaries Age 75 to 84 | 738 |
| Number Of Beneficiaries Age Greater 84 | 446 |
| Number Of Female Beneficiaries | 1913 |
| Number Of Male Beneficiaries | 971 |
| Number Of Non Hispanic White Beneficiaries | 2549 |
| Number Of Black or African American Beneficiaries | 175 |
| Number Of AsianPacific Islander Beneficiaries | 43 |
| Number Of Hispanic Beneficiaries | 68 |
| Number Of American Indian Alaska Native Beneficiaries | 15 |
| Number Of Beneficiaries With Race Not Else where Classified | 34 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2067 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 817 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.482 |