| National Provider Identifier [NPI]: | 1477529626 |
| Last Name Of The Provider | KALLENBACH |
| First Name Of The Provider | KYLE |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 430 PENNSYLVANIA AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | GLEN ELLYN |
| Zip Code Of The Provider | 601374464 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 116 |
| Number Of Services | 21616 |
| Number Of Medicare Beneficiaries | 2065 |
| Total Submitted Charge Amount | 1848762 |
| Total Medicare Allowed Amount | 511282.7 |
| Total Medicare Payment Amount | 383414.08 |
| Total Medicare Standardized Payment Amount | 371338.87 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 18864 |
| Number Of Medicare Beneficiaries With Drug Services | 225 |
| Total Drug Submitted ChargeAmount | 37899 |
| Total Drug Medicare AllowedAmount | 4623.82 |
| Total Drug Medicare PaymentAmount | 3594.84 |
| Total Drug Medicare Standardized Payment Amount | 3594.84 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 113 |
| Number Of Medical Services | 2752 |
| Number Of Medicare Beneficiaries With Medical Services | 2065 |
| Total Medical Submitted Charge Amount | 1810863 |
| Total Medical Medicare Allowed Amount | 506658.88 |
| Total Medical Medicare Payment Amount | 379819.24 |
| Total Medical Medicare Standardized Payment Amount | 367744.03 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 153 |
| Number Of Beneficiaries Age 65 to 74 | 1055 |
| Number Of Beneficiaries Age 75 to 84 | 628 |
| Number Of Beneficiaries Age Greater 84 | 229 |
| Number Of Female Beneficiaries | 1195 |
| Number Of Male Beneficiaries | 870 |
| Number Of Non Hispanic White Beneficiaries | 1793 |
| Number Of Black or African American Beneficiaries | 60 |
| Number Of AsianPacific Islander Beneficiaries | 93 |
| Number Of Hispanic Beneficiaries | 75 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1901 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 164 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.1092 |