| National Provider Identifier [NPI]: | 1942408661 |
| Last Name Of The Provider | KINZIE |
| First Name Of The Provider | MATTHEW |
| 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 | 395 W 12TH AVE |
| Street Address 2 Of The Provider | ROOM 460 |
| City Of The Provider | COLUMBUS |
| Zip Code Of The Provider | 432101267 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 77 |
| Number Of Services | 3025 |
| Number Of Medicare Beneficiaries | 2235 |
| Total Submitted Charge Amount | 643207 |
| Total Medicare Allowed Amount | 182935.58 |
| Total Medicare Payment Amount | 137047.58 |
| Total Medicare Standardized Payment Amount | 142100.4 |
| 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 | 77 |
| Number Of Medical Services | 3025 |
| Number Of Medicare Beneficiaries With Medical Services | 2235 |
| Total Medical Submitted Charge Amount | 643207 |
| Total Medical Medicare Allowed Amount | 182935.58 |
| Total Medical Medicare Payment Amount | 137047.58 |
| Total Medical Medicare Standardized Payment Amount | 142100.4 |
| Average Age Of Beneficiaries | 66 |
| Number Of Beneficiaries Age Less65 | 749 |
| Number Of Beneficiaries Age 65 to 74 | 897 |
| Number Of Beneficiaries Age 75 to 84 | 468 |
| Number Of Beneficiaries Age Greater 84 | 121 |
| Number Of Female Beneficiaries | 1064 |
| Number Of Male Beneficiaries | 1171 |
| Number Of Non Hispanic White Beneficiaries | 1815 |
| Number Of Black or African American Beneficiaries | 334 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 27 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 42 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1472 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 763 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 22 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 53 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 51 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 2.4773 |