| National Provider Identifier [NPI]: | 1578533303 |
| Last Name Of The Provider | KUSUDA |
| First Name Of The Provider | LEO |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1900 WOODLAND DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | COOS BAY |
| Zip Code Of The Provider | 974200000 |
| State Code Of The Provider | OR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 122 |
| Number Of Services | 9040 |
| Number Of Medicare Beneficiaries | 1024 |
| Total Submitted Charge Amount | 954566 |
| Total Medicare Allowed Amount | 339557.76 |
| Total Medicare Payment Amount | 253759.66 |
| Total Medicare Standardized Payment Amount | 262054.46 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 6122 |
| Number Of Medicare Beneficiaries With Drug Services | 90 |
| Total Drug Submitted ChargeAmount | 64692 |
| Total Drug Medicare AllowedAmount | 39831.16 |
| Total Drug Medicare PaymentAmount | 30854.21 |
| Total Drug Medicare Standardized Payment Amount | 30854.21 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 116 |
| Number Of Medical Services | 2918 |
| Number Of Medicare Beneficiaries With Medical Services | 1024 |
| Total Medical Submitted Charge Amount | 889874 |
| Total Medical Medicare Allowed Amount | 299726.6 |
| Total Medical Medicare Payment Amount | 222905.45 |
| Total Medical Medicare Standardized Payment Amount | 231200.25 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 111 |
| Number Of Beneficiaries Age 65 to 74 | 446 |
| Number Of Beneficiaries Age 75 to 84 | 353 |
| Number Of Beneficiaries Age Greater 84 | 114 |
| Number Of Female Beneficiaries | 261 |
| Number Of Male Beneficiaries | 763 |
| Number Of Non Hispanic White Beneficiaries | 966 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 14 |
| Number Of American Indian Alaska Native Beneficiaries | 13 |
| Number Of Beneficiaries With Race Not Else where Classified | 20 |
| Number Of Beneficiaries With Medicare Only Entitlement | 807 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 217 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 21 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.1563 |