| National Provider Identifier [NPI]: | 1598728164 |
| Last Name Of The Provider | HUBBERT |
| First Name Of The Provider | THEODORE |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 842 E MAIN ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | MEDFORD |
| Zip Code Of The Provider | 975047134 |
| State Code Of The Provider | OR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 211 |
| Number Of Services | 6181 |
| Number Of Medicare Beneficiaries | 3286 |
| Total Submitted Charge Amount | 500452.56 |
| Total Medicare Allowed Amount | 157989.32 |
| Total Medicare Payment Amount | 122366.5 |
| Total Medicare Standardized Payment Amount | 127966.26 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 1455 |
| Number Of Medicare Beneficiaries With Drug Services | 19 |
| Total Drug Submitted ChargeAmount | 2719.8 |
| Total Drug Medicare AllowedAmount | 578.53 |
| Total Drug Medicare PaymentAmount | 453.57 |
| Total Drug Medicare Standardized Payment Amount | 453.57 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 209 |
| Number Of Medical Services | 4726 |
| Number Of Medicare Beneficiaries With Medical Services | 3286 |
| Total Medical Submitted Charge Amount | 497732.76 |
| Total Medical Medicare Allowed Amount | 157410.79 |
| Total Medical Medicare Payment Amount | 121912.93 |
| Total Medical Medicare Standardized Payment Amount | 127512.69 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 531 |
| Number Of Beneficiaries Age 65 to 74 | 1365 |
| Number Of Beneficiaries Age 75 to 84 | 910 |
| Number Of Beneficiaries Age Greater 84 | 480 |
| Number Of Female Beneficiaries | 1906 |
| Number Of Male Beneficiaries | 1380 |
| Number Of Non Hispanic White Beneficiaries | 3085 |
| Number Of Black or African American Beneficiaries | 16 |
| Number Of AsianPacific Islander Beneficiaries | 21 |
| Number Of Hispanic Beneficiaries | 95 |
| Number Of American Indian Alaska Native Beneficiaries | 26 |
| Number Of Beneficiaries With Race Not Else where Classified | 43 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2527 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 759 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.3964 |