| National Provider Identifier [NPI]: | 1104833920 |
| Last Name Of The Provider | KUEHN-HAJDER |
| First Name Of The Provider | JESSICA |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 516 DELAWARE ST SE |
| Street Address 2 Of The Provider | FIRST FLOOR PWB, CLINIC 1-D |
| City Of The Provider | MINNEAPOLIS |
| Zip Code Of The Provider | 554550356 |
| 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 | 112 |
| Number Of Services | 3849 |
| Number Of Medicare Beneficiaries | 1229 |
| Total Submitted Charge Amount | 387459.1 |
| Total Medicare Allowed Amount | 97078.42 |
| Total Medicare Payment Amount | 76303.13 |
| Total Medicare Standardized Payment Amount | 79452.94 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 1356 |
| Number Of Medicare Beneficiaries With Drug Services | 14 |
| Total Drug Submitted ChargeAmount | 1438.1 |
| Total Drug Medicare AllowedAmount | 319.39 |
| Total Drug Medicare PaymentAmount | 227.09 |
| Total Drug Medicare Standardized Payment Amount | 227.09 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 110 |
| Number Of Medical Services | 2493 |
| Number Of Medicare Beneficiaries With Medical Services | 1228 |
| Total Medical Submitted Charge Amount | 386021 |
| Total Medical Medicare Allowed Amount | 96759.03 |
| Total Medical Medicare Payment Amount | 76076.04 |
| Total Medical Medicare Standardized Payment Amount | 79225.85 |
| Average Age Of Beneficiaries | 63 |
| Number Of Beneficiaries Age Less65 | 583 |
| Number Of Beneficiaries Age 65 to 74 | 358 |
| Number Of Beneficiaries Age 75 to 84 | 200 |
| Number Of Beneficiaries Age Greater 84 | 88 |
| Number Of Female Beneficiaries | 775 |
| Number Of Male Beneficiaries | 454 |
| Number Of Non Hispanic White Beneficiaries | 990 |
| Number Of Black or African American Beneficiaries | 140 |
| Number Of AsianPacific Islander Beneficiaries | 35 |
| Number Of Hispanic Beneficiaries | 16 |
| Number Of American Indian Alaska Native Beneficiaries | 27 |
| Number Of Beneficiaries With Race Not Else where Classified | 21 |
| Number Of Beneficiaries With Medicare Only Entitlement | 689 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 540 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 50 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 47 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 2.5475 |