| National Provider Identifier [NPI]: | 1043249485 |
| Last Name Of The Provider | HUDSON |
| First Name Of The Provider | CLEVELAND |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5000 W 4TH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | HATTIESBURG |
| Zip Code Of The Provider | 394021000 |
| State Code Of The Provider | MS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 220 |
| Number Of Services | 19913 |
| Number Of Medicare Beneficiaries | 5890 |
| Total Submitted Charge Amount | 2558764.5 |
| Total Medicare Allowed Amount | 503962.96 |
| Total Medicare Payment Amount | 374480.18 |
| Total Medicare Standardized Payment Amount | 418106.51 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 10971 |
| Number Of Medicare Beneficiaries With Drug Services | 228 |
| Total Drug Submitted ChargeAmount | 23714.5 |
| Total Drug Medicare AllowedAmount | 6153.39 |
| Total Drug Medicare PaymentAmount | 4617.42 |
| Total Drug Medicare Standardized Payment Amount | 4617.42 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 216 |
| Number Of Medical Services | 8942 |
| Number Of Medicare Beneficiaries With Medical Services | 5890 |
| Total Medical Submitted Charge Amount | 2535050 |
| Total Medical Medicare Allowed Amount | 497809.57 |
| Total Medical Medicare Payment Amount | 369862.76 |
| Total Medical Medicare Standardized Payment Amount | 413489.09 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 1443 |
| Number Of Beneficiaries Age 65 to 74 | 2187 |
| Number Of Beneficiaries Age 75 to 84 | 1604 |
| Number Of Beneficiaries Age Greater 84 | 656 |
| Number Of Female Beneficiaries | 3393 |
| Number Of Male Beneficiaries | 2497 |
| Number Of Non Hispanic White Beneficiaries | 4519 |
| Number Of Black or African American Beneficiaries | 1312 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 23 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 20 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3700 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 2190 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 31 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 55 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.6497 |