| National Provider Identifier [NPI]: | 1942283858 |
| Last Name Of The Provider | CUSHMAN |
| First Name Of The Provider | JEFFREY |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7901 SCHATZ POINTE DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | DAYTON |
| Zip Code Of The Provider | 454593856 |
| 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 | 166 |
| Number Of Services | 7256 |
| Number Of Medicare Beneficiaries | 4885 |
| Total Submitted Charge Amount | 860168 |
| Total Medicare Allowed Amount | 215935.05 |
| Total Medicare Payment Amount | 165919.76 |
| Total Medicare Standardized Payment Amount | 170926.75 |
| 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 | 7256 |
| Number Of Medicare Beneficiaries With Medical Services | 4885 |
| Total Medical Submitted Charge Amount | 860168 |
| Total Medical Medicare Allowed Amount | 215935.05 |
| Total Medical Medicare Payment Amount | 165919.76 |
| Total Medical Medicare Standardized Payment Amount | 170926.75 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 975 |
| Number Of Beneficiaries Age 65 to 74 | 1680 |
| Number Of Beneficiaries Age 75 to 84 | 1378 |
| Number Of Beneficiaries Age Greater 84 | 852 |
| Number Of Female Beneficiaries | 2982 |
| Number Of Male Beneficiaries | 1903 |
| Number Of Non Hispanic White Beneficiaries | 4409 |
| Number Of Black or African American Beneficiaries | 330 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 43 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 65 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3602 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1283 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 22 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 36 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.8113 |