| National Provider Identifier [NPI]: | 1629282306 |
| Last Name Of The Provider | CUDA |
| First Name Of The Provider | JEREMY |
| Middle Initial Of The Provider | F |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5221 US ROUTE 60 |
| Street Address 2 Of The Provider | |
| City Of The Provider | HUNTINGTON |
| Zip Code Of The Provider | 257052022 |
| State Code Of The Provider | WV |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 199 |
| Number Of Services | 9423 |
| Number Of Medicare Beneficiaries | 5095 |
| Total Submitted Charge Amount | 1020473.5 |
| Total Medicare Allowed Amount | 229612.46 |
| Total Medicare Payment Amount | 168988.68 |
| Total Medicare Standardized Payment Amount | 180142.42 |
| Drug Suppress Indicator | * |
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| Medical SuppressIndicator | # |
| Number Of HCPCS Associated With MedicalServices | |
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| Number Of Medicare Beneficiaries With Medical Services | |
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| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 1639 |
| Number Of Beneficiaries Age 65 to 74 | 1816 |
| Number Of Beneficiaries Age 75 to 84 | 1137 |
| Number Of Beneficiaries Age Greater 84 | 503 |
| Number Of Female Beneficiaries | 2913 |
| Number Of Male Beneficiaries | 2182 |
| Number Of Non Hispanic White Beneficiaries | 4933 |
| Number Of Black or African American Beneficiaries | 106 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 15 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 30 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3014 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 2081 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 31 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 40 |
| Percent Of With Depression | 38 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 53 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.6865 |