| National Provider Identifier [NPI]: | 1265698450 |
| Last Name Of The Provider | BERTRAND |
| First Name Of The Provider | KYLE |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1120 SOUTH DR |
| Street Address 2 Of The Provider | FESLER HALL 224 |
| City Of The Provider | INDIANAPOLIS |
| Zip Code Of The Provider | 462025135 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 193 |
| Number Of Services | 7322 |
| Number Of Medicare Beneficiaries | 4503 |
| Total Submitted Charge Amount | 907874 |
| Total Medicare Allowed Amount | 163161 |
| Total Medicare Payment Amount | 124644.97 |
| Total Medicare Standardized Payment Amount | 126983.25 |
| 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 | 193 |
| Number Of Medical Services | 7322 |
| Number Of Medicare Beneficiaries With Medical Services | 4503 |
| Total Medical Submitted Charge Amount | 907874 |
| Total Medical Medicare Allowed Amount | 163161 |
| Total Medical Medicare Payment Amount | 124644.97 |
| Total Medical Medicare Standardized Payment Amount | 126983.25 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 764 |
| Number Of Beneficiaries Age 65 to 74 | 1712 |
| Number Of Beneficiaries Age 75 to 84 | 1311 |
| Number Of Beneficiaries Age Greater 84 | 716 |
| Number Of Female Beneficiaries | 2590 |
| Number Of Male Beneficiaries | 1913 |
| Number Of Non Hispanic White Beneficiaries | 4196 |
| Number Of Black or African American Beneficiaries | 189 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 51 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 43 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3377 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1126 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 34 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 34 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.627 |