| National Provider Identifier [NPI]: | 1679577191 |
| Last Name Of The Provider | HUSTED |
| First Name Of The Provider | ROGER |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1561 ROUTE 9W |
| Street Address 2 Of The Provider | |
| City Of The Provider | LAKE KATRINE |
| Zip Code Of The Provider | 124495410 |
| State Code Of The Provider | NY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 59 |
| Number Of Services | 2365.2 |
| Number Of Medicare Beneficiaries | 1035 |
| Total Submitted Charge Amount | 470829.8 |
| Total Medicare Allowed Amount | 343435.3 |
| Total Medicare Payment Amount | 248231.13 |
| Total Medicare Standardized Payment Amount | 237518.48 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 94.2 |
| Number Of Medicare Beneficiaries With Drug Services | 11 |
| Total Drug Submitted ChargeAmount | 30300.4 |
| Total Drug Medicare AllowedAmount | 30047.66 |
| Total Drug Medicare PaymentAmount | 23564.39 |
| Total Drug Medicare Standardized Payment Amount | 23564.39 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 54 |
| Number Of Medical Services | 2271 |
| Number Of Medicare Beneficiaries With Medical Services | 1035 |
| Total Medical Submitted Charge Amount | 440529.4 |
| Total Medical Medicare Allowed Amount | 313387.64 |
| Total Medical Medicare Payment Amount | 224666.74 |
| Total Medical Medicare Standardized Payment Amount | 213954.09 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 95 |
| Number Of Beneficiaries Age 65 to 74 | 437 |
| Number Of Beneficiaries Age 75 to 84 | 350 |
| Number Of Beneficiaries Age Greater 84 | 153 |
| Number Of Female Beneficiaries | 597 |
| Number Of Male Beneficiaries | 438 |
| Number Of Non Hispanic White Beneficiaries | 970 |
| Number Of Black or African American Beneficiaries | 18 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 25 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 879 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 156 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.0474 |