| National Provider Identifier [NPI]: | 1841379260 |
| Last Name Of The Provider | CHUSID |
| First Name Of The Provider | RONALD |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1762 OAK AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | MUSKEGON |
| Zip Code Of The Provider | 494422407 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 52 |
| Number Of Services | 10082 |
| Number Of Medicare Beneficiaries | 1021 |
| Total Submitted Charge Amount | 501612 |
| Total Medicare Allowed Amount | 313186.19 |
| Total Medicare Payment Amount | 247957.81 |
| Total Medicare Standardized Payment Amount | 255407.48 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 165 |
| Number Of Medicare Beneficiaries With Drug Services | 148 |
| Total Drug Submitted ChargeAmount | 3880 |
| Total Drug Medicare AllowedAmount | 3752.19 |
| Total Drug Medicare PaymentAmount | 3676.81 |
| Total Drug Medicare Standardized Payment Amount | 3676.81 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 50 |
| Number Of Medical Services | 9917 |
| Number Of Medicare Beneficiaries With Medical Services | 1021 |
| Total Medical Submitted Charge Amount | 497732 |
| Total Medical Medicare Allowed Amount | 309434 |
| Total Medical Medicare Payment Amount | 244281 |
| Total Medical Medicare Standardized Payment Amount | 251730.67 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 304 |
| Number Of Beneficiaries Age 65 to 74 | 300 |
| Number Of Beneficiaries Age 75 to 84 | 259 |
| Number Of Beneficiaries Age Greater 84 | 158 |
| Number Of Female Beneficiaries | 538 |
| Number Of Male Beneficiaries | 483 |
| Number Of Non Hispanic White Beneficiaries | 804 |
| Number Of Black or African American Beneficiaries | 168 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 31 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 628 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 393 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 43 |
| Percent Of With Chronic Kidney Disease | 45 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 47 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 56 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.9663 |