| National Provider Identifier [NPI]: | 1306845821 |
| Last Name Of The Provider | KNUDTSON |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 551 N HILLSIDE ST |
| Street Address 2 Of The Provider | SUITE 320 |
| City Of The Provider | WICHITA |
| Zip Code Of The Provider | 672144923 |
| State Code Of The Provider | KS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 213 |
| Number Of Services | 9138 |
| Number Of Medicare Beneficiaries | 3050 |
| Total Submitted Charge Amount | 800659.3 |
| Total Medicare Allowed Amount | 279745.17 |
| Total Medicare Payment Amount | 226565.03 |
| Total Medicare Standardized Payment Amount | 245634.54 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 4087 |
| Number Of Medicare Beneficiaries With Drug Services | 59 |
| Total Drug Submitted ChargeAmount | 1312.3 |
| Total Drug Medicare AllowedAmount | 1198.81 |
| Total Drug Medicare PaymentAmount | 891.61 |
| Total Drug Medicare Standardized Payment Amount | 891.61 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 211 |
| Number Of Medical Services | 5051 |
| Number Of Medicare Beneficiaries With Medical Services | 3048 |
| Total Medical Submitted Charge Amount | 799347 |
| Total Medical Medicare Allowed Amount | 278546.36 |
| Total Medical Medicare Payment Amount | 225673.42 |
| Total Medical Medicare Standardized Payment Amount | 244742.93 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 497 |
| Number Of Beneficiaries Age 65 to 74 | 1182 |
| Number Of Beneficiaries Age 75 to 84 | 911 |
| Number Of Beneficiaries Age Greater 84 | 460 |
| Number Of Female Beneficiaries | 2162 |
| Number Of Male Beneficiaries | 888 |
| Number Of Non Hispanic White Beneficiaries | 2676 |
| Number Of Black or African American Beneficiaries | 196 |
| Number Of AsianPacific Islander Beneficiaries | 42 |
| Number Of Hispanic Beneficiaries | 92 |
| Number Of American Indian Alaska Native Beneficiaries | 19 |
| Number Of Beneficiaries With Race Not Else where Classified | 25 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2469 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 581 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.4528 |