| National Provider Identifier [NPI]: | 1063466837 |
| Last Name Of The Provider | BORTEL |
| First Name Of The Provider | KIRK |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3009 N SAGINAW RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | MIDLAND |
| Zip Code Of The Provider | 486404555 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 48 |
| Number Of Services | 305 |
| Number Of Medicare Beneficiaries | 160 |
| Total Submitted Charge Amount | 36444 |
| Total Medicare Allowed Amount | 16213.16 |
| Total Medicare Payment Amount | 10935.98 |
| Total Medicare Standardized Payment Amount | 11555.81 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 48 |
| Number Of Medicare Beneficiaries With Drug Services | 14 |
| Total Drug Submitted ChargeAmount | 400 |
| Total Drug Medicare AllowedAmount | 14.68 |
| Total Drug Medicare PaymentAmount | 9.25 |
| Total Drug Medicare Standardized Payment Amount | 9.25 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 45 |
| Number Of Medical Services | 257 |
| Number Of Medicare Beneficiaries With Medical Services | 160 |
| Total Medical Submitted Charge Amount | 36044 |
| Total Medical Medicare Allowed Amount | 16198.48 |
| Total Medical Medicare Payment Amount | 10926.73 |
| Total Medical Medicare Standardized Payment Amount | 11546.56 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 46 |
| Number Of Beneficiaries Age 65 to 74 | 49 |
| Number Of Beneficiaries Age 75 to 84 | 47 |
| Number Of Beneficiaries Age Greater 84 | 18 |
| Number Of Female Beneficiaries | 96 |
| Number Of Male Beneficiaries | 64 |
| 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 | 124 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 36 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 19 |
| Percent Of With Hyperlipidemia | 43 |
| Percent Of With Hypertension | 53 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9011 |