| National Provider Identifier [NPI]: | 1770554271 |
| Last Name Of The Provider | HILDEBRANDT |
| First Name Of The Provider | KURT |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 34800 BOB WILSON DR |
| Street Address 2 Of The Provider | NMCSD, ATTN: MEDICAL STAFF SERVICES |
| City Of The Provider | SAN DIEGO |
| Zip Code Of The Provider | 921341098 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 206 |
| Number Of Services | 26517 |
| Number Of Medicare Beneficiaries | 4235 |
| Total Submitted Charge Amount | 1717762.4 |
| Total Medicare Allowed Amount | 383135.86 |
| Total Medicare Payment Amount | 288099.6 |
| Total Medicare Standardized Payment Amount | 279634.97 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 20520 |
| Number Of Medicare Beneficiaries With Drug Services | 256 |
| Total Drug Submitted ChargeAmount | 21828 |
| Total Drug Medicare AllowedAmount | 4630.06 |
| Total Drug Medicare PaymentAmount | 3562.59 |
| Total Drug Medicare Standardized Payment Amount | 3562.59 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 196 |
| Number Of Medical Services | 5997 |
| Number Of Medicare Beneficiaries With Medical Services | 4234 |
| Total Medical Submitted Charge Amount | 1695934.4 |
| Total Medical Medicare Allowed Amount | 378505.8 |
| Total Medical Medicare Payment Amount | 284537.01 |
| Total Medical Medicare Standardized Payment Amount | 276072.38 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 805 |
| Number Of Beneficiaries Age 65 to 74 | 1576 |
| Number Of Beneficiaries Age 75 to 84 | 1184 |
| Number Of Beneficiaries Age Greater 84 | 670 |
| Number Of Female Beneficiaries | 2395 |
| Number Of Male Beneficiaries | 1840 |
| Number Of Non Hispanic White Beneficiaries | 2362 |
| Number Of Black or African American Beneficiaries | 277 |
| Number Of AsianPacific Islander Beneficiaries | 315 |
| Number Of Hispanic Beneficiaries | 1184 |
| Number Of American Indian Alaska Native Beneficiaries | 42 |
| Number Of Beneficiaries With Race Not Else where Classified | 55 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2230 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 2005 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 18 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 37 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 48 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 51 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.935 |