| National Provider Identifier [NPI]: | 1306991336 |
| Last Name Of The Provider | HUDDLESTON |
| First Name Of The Provider | DON |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1605 MARTIN SPRINGS DR |
| Street Address 2 Of The Provider | STE 110 |
| City Of The Provider | ROLLA |
| Zip Code Of The Provider | 654012982 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 199 |
| Number Of Services | 30947 |
| Number Of Medicare Beneficiaries | 2623 |
| Total Submitted Charge Amount | 4703409.01 |
| Total Medicare Allowed Amount | 534461.89 |
| Total Medicare Payment Amount | 410859.92 |
| Total Medicare Standardized Payment Amount | 462348.9 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 23 |
| Number Of Drug Services | 23383 |
| Number Of Medicare Beneficiaries With Drug Services | 349 |
| Total Drug Submitted ChargeAmount | 241488.16 |
| Total Drug Medicare AllowedAmount | 27665.06 |
| Total Drug Medicare PaymentAmount | 21503.78 |
| Total Drug Medicare Standardized Payment Amount | 21503.78 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 176 |
| Number Of Medical Services | 7564 |
| Number Of Medicare Beneficiaries With Medical Services | 2612 |
| Total Medical Submitted Charge Amount | 4461920.85 |
| Total Medical Medicare Allowed Amount | 506796.83 |
| Total Medical Medicare Payment Amount | 389356.14 |
| Total Medical Medicare Standardized Payment Amount | 440845.12 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 651 |
| Number Of Beneficiaries Age 65 to 74 | 1077 |
| Number Of Beneficiaries Age 75 to 84 | 694 |
| Number Of Beneficiaries Age Greater 84 | 201 |
| Number Of Female Beneficiaries | 1639 |
| Number Of Male Beneficiaries | 984 |
| Number Of Non Hispanic White Beneficiaries | 2432 |
| Number Of Black or African American Beneficiaries | 84 |
| Number Of AsianPacific Islander Beneficiaries | 36 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 38 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2006 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 617 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.1956 |