| National Provider Identifier [NPI]: | 1073507265 |
| Last Name Of The Provider | ELLIS |
| First Name Of The Provider | KRIS |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1000 BOWER HILL RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | PITTSBURGH |
| Zip Code Of The Provider | 152431873 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 146 |
| Number Of Services | 2177 |
| Number Of Medicare Beneficiaries | 1428 |
| Total Submitted Charge Amount | 243775 |
| Total Medicare Allowed Amount | 72514.53 |
| Total Medicare Payment Amount | 53607.67 |
| Total Medicare Standardized Payment Amount | 56006.83 |
| 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 | 146 |
| Number Of Medical Services | 2177 |
| Number Of Medicare Beneficiaries With Medical Services | 1428 |
| Total Medical Submitted Charge Amount | 243775 |
| Total Medical Medicare Allowed Amount | 72514.53 |
| Total Medical Medicare Payment Amount | 53607.67 |
| Total Medical Medicare Standardized Payment Amount | 56006.83 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 124 |
| Number Of Beneficiaries Age 65 to 74 | 401 |
| Number Of Beneficiaries Age 75 to 84 | 430 |
| Number Of Beneficiaries Age Greater 84 | 473 |
| Number Of Female Beneficiaries | 891 |
| Number Of Male Beneficiaries | 537 |
| Number Of Non Hispanic White Beneficiaries | 1375 |
| Number Of Black or African American Beneficiaries | 26 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 14 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1259 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 169 |
| Percent Of With Atrial Fibrillation | 23 |
| Percent Of With Alzheimers Disease or Dementia | 23 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 1.5706 |