| National Provider Identifier [NPI]: | 1235117144 |
| Last Name Of The Provider | BRONFMAN |
| First Name Of The Provider | JASON |
| Middle Initial Of The Provider | N |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5129 DIXIE HWY |
| Street Address 2 Of The Provider | STE. 100 |
| City Of The Provider | LOUISVILLE |
| Zip Code Of The Provider | 402161727 |
| State Code Of The Provider | KY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 158 |
| Number Of Services | 5291 |
| Number Of Medicare Beneficiaries | 3369 |
| Total Submitted Charge Amount | 695297 |
| Total Medicare Allowed Amount | 166887.5 |
| Total Medicare Payment Amount | 126510.58 |
| Total Medicare Standardized Payment Amount | 134207.52 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 158 |
| Number Of Medical Services | 5291 |
| Number Of Medicare Beneficiaries With Medical Services | 3369 |
| Total Medical Submitted Charge Amount | 695297 |
| Total Medical Medicare Allowed Amount | 166887.5 |
| Total Medical Medicare Payment Amount | 126510.58 |
| Total Medical Medicare Standardized Payment Amount | 134207.52 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 862 |
| Number Of Beneficiaries Age 65 to 74 | 1160 |
| Number Of Beneficiaries Age 75 to 84 | 912 |
| Number Of Beneficiaries Age Greater 84 | 435 |
| Number Of Female Beneficiaries | 2202 |
| Number Of Male Beneficiaries | 1167 |
| Number Of Non Hispanic White Beneficiaries | 2894 |
| Number Of Black or African American Beneficiaries | 390 |
| Number Of AsianPacific Islander Beneficiaries | 30 |
| Number Of Hispanic Beneficiaries | 31 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 24 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2377 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 992 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 17 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 35 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 39 |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 50 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.8828 |