| National Provider Identifier [NPI]: | 1639157373 |
| Last Name Of The Provider | HANSEN |
| First Name Of The Provider | CALVIN |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1221 PLEASANT ST |
| Street Address 2 Of The Provider | SUITE 300 |
| City Of The Provider | DES MOINES |
| Zip Code Of The Provider | 503091423 |
| State Code Of The Provider | IA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Neurology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 73 |
| Number Of Services | 1628 |
| Number Of Medicare Beneficiaries | 594 |
| Total Submitted Charge Amount | 333836 |
| Total Medicare Allowed Amount | 162563.95 |
| Total Medicare Payment Amount | 121368.2 |
| Total Medicare Standardized Payment Amount | 128288.01 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 348 |
| Number Of Medicare Beneficiaries With Drug Services | 26 |
| Total Drug Submitted ChargeAmount | 128075 |
| Total Drug Medicare AllowedAmount | 64123.96 |
| Total Drug Medicare PaymentAmount | 50152.7 |
| Total Drug Medicare Standardized Payment Amount | 50152.7 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 70 |
| Number Of Medical Services | 1280 |
| Number Of Medicare Beneficiaries With Medical Services | 594 |
| Total Medical Submitted Charge Amount | 205761 |
| Total Medical Medicare Allowed Amount | 98439.99 |
| Total Medical Medicare Payment Amount | 71215.5 |
| Total Medical Medicare Standardized Payment Amount | 78135.31 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 122 |
| Number Of Beneficiaries Age 65 to 74 | 188 |
| Number Of Beneficiaries Age 75 to 84 | 191 |
| Number Of Beneficiaries Age Greater 84 | 93 |
| Number Of Female Beneficiaries | 320 |
| Number Of Male Beneficiaries | 274 |
| Number Of Non Hispanic White Beneficiaries | 566 |
| Number Of Black or African American Beneficiaries | 15 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 457 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 137 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 12 |
| Percent Of With Stroke | 28 |
| Average HCC Risk Score Of Beneficiaries | 1.4554 |