| National Provider Identifier [NPI]: | 1508881764 |
| Last Name Of The Provider | RUDERMAN |
| First Name Of The Provider | RICHARD |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2008 CARIBOU DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | FORT COLLINS |
| Zip Code Of The Provider | 805254325 |
| State Code Of The Provider | CO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 177 |
| Number Of Services | 4385 |
| Number Of Medicare Beneficiaries | 2725 |
| Total Submitted Charge Amount | 299510 |
| Total Medicare Allowed Amount | 110329.58 |
| Total Medicare Payment Amount | 82160.57 |
| Total Medicare Standardized Payment Amount | 83292.62 |
| 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 | 177 |
| Number Of Medical Services | 4385 |
| Number Of Medicare Beneficiaries With Medical Services | 2725 |
| Total Medical Submitted Charge Amount | 299510 |
| Total Medical Medicare Allowed Amount | 110329.58 |
| Total Medical Medicare Payment Amount | 82160.57 |
| Total Medical Medicare Standardized Payment Amount | 83292.62 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 497 |
| Number Of Beneficiaries Age 65 to 74 | 923 |
| Number Of Beneficiaries Age 75 to 84 | 790 |
| Number Of Beneficiaries Age Greater 84 | 515 |
| Number Of Female Beneficiaries | 1540 |
| Number Of Male Beneficiaries | 1185 |
| Number Of Non Hispanic White Beneficiaries | 2267 |
| Number Of Black or African American Beneficiaries | 13 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 399 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 24 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1996 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 729 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 33 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.5883 |