| National Provider Identifier [NPI]: | 1528058393 |
| Last Name Of The Provider | ELLIOTT |
| First Name Of The Provider | ERIC |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5901 TECHNOLOGY CENTER DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | INDIANAPOLIS |
| Zip Code Of The Provider | 462786013 |
| 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 | 188 |
| Number Of Services | 11362 |
| Number Of Medicare Beneficiaries | 7954 |
| Total Submitted Charge Amount | 851772 |
| Total Medicare Allowed Amount | 284596 |
| Total Medicare Payment Amount | 217608.85 |
| Total Medicare Standardized Payment Amount | 230054.49 |
| Drug Suppress Indicator | * |
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| Medical SuppressIndicator | # |
| Number Of HCPCS Associated With MedicalServices | |
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| Number Of Medicare Beneficiaries With Medical Services | |
| Total Medical Submitted Charge Amount | |
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| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 1502 |
| Number Of Beneficiaries Age 65 to 74 | 2786 |
| Number Of Beneficiaries Age 75 to 84 | 2301 |
| Number Of Beneficiaries Age Greater 84 | 1365 |
| Number Of Female Beneficiaries | 4743 |
| Number Of Male Beneficiaries | 3211 |
| Number Of Non Hispanic White Beneficiaries | 7077 |
| Number Of Black or African American Beneficiaries | 694 |
| Number Of AsianPacific Islander Beneficiaries | 53 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 72 |
| Number Of Beneficiaries With Medicare Only Entitlement | 5911 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 2043 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 33 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 32 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.6586 |