| National Provider Identifier [NPI]: | 1568648889 |
| Last Name Of The Provider | BELTZ |
| First Name Of The Provider | ERIC |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| 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 | 129 |
| Number Of Services | 9733 |
| Number Of Medicare Beneficiaries | 4387 |
| Total Submitted Charge Amount | 1208196.45 |
| Total Medicare Allowed Amount | 355912.86 |
| Total Medicare Payment Amount | 272219.82 |
| Total Medicare Standardized Payment Amount | 290243.57 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 4240 |
| Number Of Medicare Beneficiaries With Drug Services | 41 |
| Total Drug Submitted ChargeAmount | 3198 |
| Total Drug Medicare AllowedAmount | 1118.83 |
| Total Drug Medicare PaymentAmount | 866.94 |
| Total Drug Medicare Standardized Payment Amount | 866.94 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 127 |
| Number Of Medical Services | 5493 |
| Number Of Medicare Beneficiaries With Medical Services | 4387 |
| Total Medical Submitted Charge Amount | 1204998.45 |
| Total Medical Medicare Allowed Amount | 354794.03 |
| Total Medical Medicare Payment Amount | 271352.88 |
| Total Medical Medicare Standardized Payment Amount | 289376.63 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 812 |
| Number Of Beneficiaries Age 65 to 74 | 1572 |
| Number Of Beneficiaries Age 75 to 84 | 1291 |
| Number Of Beneficiaries Age Greater 84 | 712 |
| Number Of Female Beneficiaries | 2573 |
| Number Of Male Beneficiaries | 1814 |
| Number Of Non Hispanic White Beneficiaries | 3929 |
| Number Of Black or African American Beneficiaries | 353 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 35 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 42 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3316 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1071 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 18 |
| Average HCC Risk Score Of Beneficiaries | 1.5547 |