| National Provider Identifier [NPI]: | 1609874049 |
| Last Name Of The Provider | HOERTZ |
| First Name Of The Provider | STEWART |
| 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 | 200 E CHESTNUT ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | LOUISVILLE |
| Zip Code Of The Provider | 402021831 |
| State Code Of The Provider | KY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 198 |
| Number Of Services | 5449 |
| Number Of Medicare Beneficiaries | 3413 |
| Total Submitted Charge Amount | 393211 |
| Total Medicare Allowed Amount | 146590.96 |
| Total Medicare Payment Amount | 114097.58 |
| Total Medicare Standardized Payment Amount | 122031.74 |
| 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 | 198 |
| Number Of Medical Services | 5449 |
| Number Of Medicare Beneficiaries With Medical Services | 3413 |
| Total Medical Submitted Charge Amount | 393211 |
| Total Medical Medicare Allowed Amount | 146590.96 |
| Total Medical Medicare Payment Amount | 114097.58 |
| Total Medical Medicare Standardized Payment Amount | 122031.74 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 911 |
| Number Of Beneficiaries Age 65 to 74 | 1352 |
| Number Of Beneficiaries Age 75 to 84 | 782 |
| Number Of Beneficiaries Age Greater 84 | 368 |
| Number Of Female Beneficiaries | 2211 |
| Number Of Male Beneficiaries | 1202 |
| Number Of Non Hispanic White Beneficiaries | 2722 |
| Number Of Black or African American Beneficiaries | 595 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 29 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 41 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2427 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 986 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 34 |
| Percent Of With Depression | 38 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.8159 |