| National Provider Identifier [NPI]: | 1225027592 |
| Last Name Of The Provider | GORMEZANO |
| First Name Of The Provider | KYLE |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 500 PEACOCK LN N |
| Street Address 2 Of The Provider | |
| City Of The Provider | JUPITER |
| Zip Code Of The Provider | 334588333 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 166 |
| Number Of Services | 3975 |
| Number Of Medicare Beneficiaries | 2038 |
| Total Submitted Charge Amount | 400871 |
| Total Medicare Allowed Amount | 114167.01 |
| Total Medicare Payment Amount | 88868.04 |
| Total Medicare Standardized Payment Amount | 85714.47 |
| 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 | 166 |
| Number Of Medical Services | 3975 |
| Number Of Medicare Beneficiaries With Medical Services | 2038 |
| Total Medical Submitted Charge Amount | 400871 |
| Total Medical Medicare Allowed Amount | 114167.01 |
| Total Medical Medicare Payment Amount | 88868.04 |
| Total Medical Medicare Standardized Payment Amount | 85714.47 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 412 |
| Number Of Beneficiaries Age 65 to 74 | 674 |
| Number Of Beneficiaries Age 75 to 84 | 592 |
| Number Of Beneficiaries Age Greater 84 | 360 |
| Number Of Female Beneficiaries | 1286 |
| Number Of Male Beneficiaries | 752 |
| Number Of Non Hispanic White Beneficiaries | 1265 |
| Number Of Black or African American Beneficiaries | 506 |
| Number Of AsianPacific Islander Beneficiaries | 19 |
| Number Of Hispanic Beneficiaries | 228 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1281 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 757 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 55 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.9632 |