| National Provider Identifier [NPI]: | 1992786750 |
| Last Name Of The Provider | NUDO |
| First Name Of The Provider | STEVEN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | PALOS COMMUNITY HOSPITAL |
| Street Address 2 Of The Provider | 7808 COLLEGE DRIVE !SE |
| City Of The Provider | PALOS HEIGHTS |
| Zip Code Of The Provider | 60463 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 144 |
| Number Of Services | 4074 |
| Number Of Medicare Beneficiaries | 2642 |
| Total Submitted Charge Amount | 474396 |
| Total Medicare Allowed Amount | 134939.02 |
| Total Medicare Payment Amount | 99996.48 |
| Total Medicare Standardized Payment Amount | 94601.78 |
| 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 | 144 |
| Number Of Medical Services | 4074 |
| Number Of Medicare Beneficiaries With Medical Services | 2642 |
| Total Medical Submitted Charge Amount | 474396 |
| Total Medical Medicare Allowed Amount | 134939.02 |
| Total Medical Medicare Payment Amount | 99996.48 |
| Total Medical Medicare Standardized Payment Amount | 94601.78 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 266 |
| Number Of Beneficiaries Age 65 to 74 | 793 |
| Number Of Beneficiaries Age 75 to 84 | 871 |
| Number Of Beneficiaries Age Greater 84 | 712 |
| Number Of Female Beneficiaries | 1564 |
| Number Of Male Beneficiaries | 1078 |
| Number Of Non Hispanic White Beneficiaries | 2396 |
| Number Of Black or African American Beneficiaries | 118 |
| Number Of AsianPacific Islander Beneficiaries | 31 |
| Number Of Hispanic Beneficiaries | 75 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2234 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 408 |
| Percent Of With Atrial Fibrillation | 28 |
| Percent Of With Alzheimers Disease or Dementia | 27 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 46 |
| Percent Of With Chronic Kidney Disease | 44 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 38 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 72 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 57 |
| Percent Of With Osteoporosis | 17 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 59 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 1.9254 |