| National Provider Identifier [NPI]: | 1922316744 |
| Last Name Of The Provider | KYLE-SIDELL |
| First Name Of The Provider | CAMERON |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4201 SAINT ANTOINE ST |
| Street Address 2 Of The Provider | UHC 9C |
| City Of The Provider | DETROIT |
| Zip Code Of The Provider | 482012153 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 48 |
| Number Of Services | 856 |
| Number Of Medicare Beneficiaries | 676 |
| Total Submitted Charge Amount | 670474 |
| Total Medicare Allowed Amount | 153939.78 |
| Total Medicare Payment Amount | 118428.44 |
| Total Medicare Standardized Payment Amount | 104504.66 |
| 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 | 48 |
| Number Of Medical Services | 856 |
| Number Of Medicare Beneficiaries With Medical Services | 676 |
| Total Medical Submitted Charge Amount | 670474 |
| Total Medical Medicare Allowed Amount | 153939.78 |
| Total Medical Medicare Payment Amount | 118428.44 |
| Total Medical Medicare Standardized Payment Amount | 104504.66 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 82 |
| Number Of Beneficiaries Age 65 to 74 | 159 |
| Number Of Beneficiaries Age 75 to 84 | 206 |
| Number Of Beneficiaries Age Greater 84 | 229 |
| Number Of Female Beneficiaries | 374 |
| Number Of Male Beneficiaries | 302 |
| Number Of Non Hispanic White Beneficiaries | 495 |
| Number Of Black or African American Beneficiaries | 42 |
| Number Of AsianPacific Islander Beneficiaries | 60 |
| Number Of Hispanic Beneficiaries | 56 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 23 |
| Number Of Beneficiaries With Medicare Only Entitlement | 224 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 452 |
| Percent Of With Atrial Fibrillation | 26 |
| Percent Of With Alzheimers Disease or Dementia | 41 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 59 |
| Percent Of With Chronic Kidney Disease | 46 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 66 |
| Percent Of With Hyperlipidemia | 72 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 16 |
| Average HCC Risk Score Of Beneficiaries | 2.548 |