| National Provider Identifier [NPI]: | 1124122700 |
| Last Name Of The Provider | RUDORFER |
| First Name Of The Provider | BENNETT |
| 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 | 310 WEST TYLER |
| Street Address 2 Of The Provider | |
| City Of The Provider | WEST MEMPHIS |
| Zip Code Of The Provider | 72301 |
| State Code Of The Provider | AR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 55 |
| Number Of Services | 6021 |
| Number Of Medicare Beneficiaries | 1540 |
| Total Submitted Charge Amount | 1086886 |
| Total Medicare Allowed Amount | 394261.83 |
| Total Medicare Payment Amount | 305642.6 |
| Total Medicare Standardized Payment Amount | 332177.91 |
| 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 | 55 |
| Number Of Medical Services | 6021 |
| Number Of Medicare Beneficiaries With Medical Services | 1540 |
| Total Medical Submitted Charge Amount | 1086886 |
| Total Medical Medicare Allowed Amount | 394261.83 |
| Total Medical Medicare Payment Amount | 305642.6 |
| Total Medical Medicare Standardized Payment Amount | 332177.91 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 479 |
| Number Of Beneficiaries Age 65 to 74 | 504 |
| Number Of Beneficiaries Age 75 to 84 | 397 |
| Number Of Beneficiaries Age Greater 84 | 160 |
| Number Of Female Beneficiaries | 862 |
| Number Of Male Beneficiaries | 678 |
| Number Of Non Hispanic White Beneficiaries | 695 |
| Number Of Black or African American Beneficiaries | 816 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 17 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 714 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 826 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 23 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 67 |
| Percent Of With Chronic Kidney Disease | 47 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 53 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 65 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 19 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 2.5315 |