| National Provider Identifier [NPI]: | 1407833593 |
| Last Name Of The Provider | CARLSON |
| First Name Of The Provider | KURT |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 200 1ST ST SW |
| Street Address 2 Of The Provider | |
| City Of The Provider | ROCHESTER |
| Zip Code Of The Provider | 559050001 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 19 |
| Number Of Services | 334 |
| Number Of Medicare Beneficiaries | 117 |
| Total Submitted Charge Amount | 36166.01 |
| Total Medicare Allowed Amount | 30850.44 |
| Total Medicare Payment Amount | 23725.21 |
| Total Medicare Standardized Payment Amount | 25715.7 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 37 |
| Number Of Medicare Beneficiaries With Drug Services | 29 |
| Total Drug Submitted ChargeAmount | 4285.86 |
| Total Drug Medicare AllowedAmount | 4073.65 |
| Total Drug Medicare PaymentAmount | 3781.41 |
| Total Drug Medicare Standardized Payment Amount | 3781.41 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 14 |
| Number Of Medical Services | 297 |
| Number Of Medicare Beneficiaries With Medical Services | 117 |
| Total Medical Submitted Charge Amount | 31880.15 |
| Total Medical Medicare Allowed Amount | 26776.79 |
| Total Medical Medicare Payment Amount | 19943.8 |
| Total Medical Medicare Standardized Payment Amount | 21934.29 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 66 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 36 |
| Number Of Male Beneficiaries | 81 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 117 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 0 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 11 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 11 |
| Percent Of With Diabetes | 12 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 50 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 53 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.7923 |