| National Provider Identifier [NPI]: | 1295916120 |
| Last Name Of The Provider | DALE |
| First Name Of The Provider | KYLE |
| 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 | 3205 S RUSSELL ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | MISSOULA |
| Zip Code Of The Provider | 598018536 |
| State Code Of The Provider | MT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 222 |
| Number Of Services | 4088 |
| Number Of Medicare Beneficiaries | 2635 |
| Total Submitted Charge Amount | 505439 |
| Total Medicare Allowed Amount | 169463.55 |
| Total Medicare Payment Amount | 129023.83 |
| Total Medicare Standardized Payment Amount | 128460.56 |
| 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 | 222 |
| Number Of Medical Services | 4088 |
| Number Of Medicare Beneficiaries With Medical Services | 2635 |
| Total Medical Submitted Charge Amount | 505439 |
| Total Medical Medicare Allowed Amount | 169463.55 |
| Total Medical Medicare Payment Amount | 129023.83 |
| Total Medical Medicare Standardized Payment Amount | 128460.56 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 412 |
| Number Of Beneficiaries Age 65 to 74 | 1036 |
| Number Of Beneficiaries Age 75 to 84 | 838 |
| Number Of Beneficiaries Age Greater 84 | 349 |
| Number Of Female Beneficiaries | 1340 |
| Number Of Male Beneficiaries | 1295 |
| Number Of Non Hispanic White Beneficiaries | 2464 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 23 |
| Number Of American Indian Alaska Native Beneficiaries | 103 |
| Number Of Beneficiaries With Race Not Else where Classified | 32 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2104 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 531 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 46 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.3826 |