| National Provider Identifier [NPI]: | 1104860881 |
| Last Name Of The Provider | HARRIS |
| First Name Of The Provider | TODD |
| 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 | 7340 SHADELAND STA |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | INDIANAPOLIS |
| Zip Code Of The Provider | 462563979 |
| 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 | 111 |
| Number Of Services | 4774 |
| Number Of Medicare Beneficiaries | 2777 |
| Total Submitted Charge Amount | 397892 |
| Total Medicare Allowed Amount | 148219.79 |
| Total Medicare Payment Amount | 111543.75 |
| Total Medicare Standardized Payment Amount | 118456.64 |
| 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 | 111 |
| Number Of Medical Services | 4774 |
| Number Of Medicare Beneficiaries With Medical Services | 2777 |
| Total Medical Submitted Charge Amount | 397892 |
| Total Medical Medicare Allowed Amount | 148219.79 |
| Total Medical Medicare Payment Amount | 111543.75 |
| Total Medical Medicare Standardized Payment Amount | 118456.64 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 801 |
| Number Of Beneficiaries Age 65 to 74 | 813 |
| Number Of Beneficiaries Age 75 to 84 | 690 |
| Number Of Beneficiaries Age Greater 84 | 473 |
| Number Of Female Beneficiaries | 1631 |
| Number Of Male Beneficiaries | 1146 |
| Number Of Non Hispanic White Beneficiaries | 2046 |
| Number Of Black or African American Beneficiaries | 658 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 32 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 24 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1715 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1062 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 43 |
| Percent Of With Chronic Kidney Disease | 45 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 36 |
| Percent Of With Depression | 42 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 54 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 13 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 1.9825 |