| National Provider Identifier [NPI]: | 1679559314 |
| Last Name Of The Provider | REIDER |
| First Name Of The Provider | JEFFREY |
| Middle Initial Of The Provider | I |
| 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 | 96 |
| Number Of Services | 7061 |
| Number Of Medicare Beneficiaries | 3751 |
| Total Submitted Charge Amount | 994833.05 |
| Total Medicare Allowed Amount | 287440.3 |
| Total Medicare Payment Amount | 221956.56 |
| Total Medicare Standardized Payment Amount | 234617.73 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 2440 |
| Number Of Medicare Beneficiaries With Drug Services | 24 |
| Total Drug Submitted ChargeAmount | 1794 |
| Total Drug Medicare AllowedAmount | 659.89 |
| Total Drug Medicare PaymentAmount | 517.29 |
| Total Drug Medicare Standardized Payment Amount | 517.29 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 94 |
| Number Of Medical Services | 4621 |
| Number Of Medicare Beneficiaries With Medical Services | 3751 |
| Total Medical Submitted Charge Amount | 993039.05 |
| Total Medical Medicare Allowed Amount | 286780.41 |
| Total Medical Medicare Payment Amount | 221439.27 |
| Total Medical Medicare Standardized Payment Amount | 234100.44 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 727 |
| Number Of Beneficiaries Age 65 to 74 | 1259 |
| Number Of Beneficiaries Age 75 to 84 | 1176 |
| Number Of Beneficiaries Age Greater 84 | 589 |
| Number Of Female Beneficiaries | 2252 |
| Number Of Male Beneficiaries | 1499 |
| Number Of Non Hispanic White Beneficiaries | 3345 |
| Number Of Black or African American Beneficiaries | 312 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 37 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 34 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2841 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 910 |
| 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 | 26 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 38 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 55 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 18 |
| Average HCC Risk Score Of Beneficiaries | 1.5149 |