| National Provider Identifier [NPI]: | 1083608392 |
| Last Name Of The Provider | BELT |
| First Name Of The Provider | THOMAS |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7340 SHADELAND STATION |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | INDIANAPOLIS |
| Zip Code Of The Provider | 462563980 |
| 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 | 120 |
| Number Of Services | 9028 |
| Number Of Medicare Beneficiaries | 6094 |
| Total Submitted Charge Amount | 611456.75 |
| Total Medicare Allowed Amount | 210012.57 |
| Total Medicare Payment Amount | 154790.18 |
| Total Medicare Standardized Payment Amount | 162921.23 |
| 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 | 120 |
| Number Of Medical Services | 9028 |
| Number Of Medicare Beneficiaries With Medical Services | 6094 |
| Total Medical Submitted Charge Amount | 611456.75 |
| Total Medical Medicare Allowed Amount | 210012.57 |
| Total Medical Medicare Payment Amount | 154790.18 |
| Total Medical Medicare Standardized Payment Amount | 162921.23 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 808 |
| Number Of Beneficiaries Age 65 to 74 | 2556 |
| Number Of Beneficiaries Age 75 to 84 | 1846 |
| Number Of Beneficiaries Age Greater 84 | 884 |
| Number Of Female Beneficiaries | 3716 |
| Number Of Male Beneficiaries | 2378 |
| Number Of Non Hispanic White Beneficiaries | 5815 |
| Number Of Black or African American Beneficiaries | 161 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 25 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 64 |
| Number Of Beneficiaries With Medicare Only Entitlement | 5152 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 942 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.3153 |