| National Provider Identifier [NPI]: | 1609166123 |
| Last Name Of The Provider | TUDEN |
| First Name Of The Provider | HEATHER |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2300 SOUTHWOOD DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | NASHUA |
| Zip Code Of The Provider | 030631818 |
| State Code Of The Provider | NH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 20 |
| Number Of Services | 216 |
| Number Of Medicare Beneficiaries | 111 |
| Total Submitted Charge Amount | 44593.71 |
| Total Medicare Allowed Amount | 15019.39 |
| Total Medicare Payment Amount | 9772.13 |
| Total Medicare Standardized Payment Amount | 11818.91 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 22 |
| Number Of Medicare Beneficiaries With Drug Services | 15 |
| Total Drug Submitted ChargeAmount | 1054.71 |
| Total Drug Medicare AllowedAmount | 286.69 |
| Total Drug Medicare PaymentAmount | 253.1 |
| Total Drug Medicare Standardized Payment Amount | 253.1 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 16 |
| Number Of Medical Services | 194 |
| Number Of Medicare Beneficiaries With Medical Services | 111 |
| Total Medical Submitted Charge Amount | 43539 |
| Total Medical Medicare Allowed Amount | 14732.7 |
| Total Medical Medicare Payment Amount | 9519.03 |
| Total Medical Medicare Standardized Payment Amount | 11565.81 |
| Average Age Of Beneficiaries | 64 |
| Number Of Beneficiaries Age Less65 | 36 |
| Number Of Beneficiaries Age 65 to 74 | 53 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 73 |
| Number Of Male Beneficiaries | 38 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| 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 | 85 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 26 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 18 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 43 |
| Percent Of With Ischemic Heart Disease | 17 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 23 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.874 |