| National Provider Identifier [NPI]: | 1790753374 |
| Last Name Of The Provider | HUDOCK |
| First Name Of The Provider | STEPHEN |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1 GUTHRIE SQ |
| Street Address 2 Of The Provider | |
| City Of The Provider | SAYRE |
| Zip Code Of The Provider | 188401625 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 31 |
| Number Of Services | 4206 |
| Number Of Medicare Beneficiaries | 986 |
| Total Submitted Charge Amount | 1100751.16 |
| Total Medicare Allowed Amount | 350994.75 |
| Total Medicare Payment Amount | 248348.28 |
| Total Medicare Standardized Payment Amount | 261300.14 |
| 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 | 31 |
| Number Of Medical Services | 4206 |
| Number Of Medicare Beneficiaries With Medical Services | 986 |
| Total Medical Submitted Charge Amount | 1100751.16 |
| Total Medical Medicare Allowed Amount | 350994.75 |
| Total Medical Medicare Payment Amount | 248348.28 |
| Total Medical Medicare Standardized Payment Amount | 261300.14 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 71 |
| Number Of Beneficiaries Age 65 to 74 | 302 |
| Number Of Beneficiaries Age 75 to 84 | 370 |
| Number Of Beneficiaries Age Greater 84 | 243 |
| Number Of Female Beneficiaries | 569 |
| Number Of Male Beneficiaries | 417 |
| Number Of Non Hispanic White Beneficiaries | 942 |
| Number Of Black or African American Beneficiaries | 23 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 844 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 142 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 30 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.1235 |