| National Provider Identifier [NPI]: | 1104860600 |
| Last Name Of The Provider | YUSCHOK |
| First Name Of The Provider | THOMAS |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1673 MASON AVE |
| Street Address 2 Of The Provider | SUITE # 305 |
| City Of The Provider | DAYTONA BEACH |
| Zip Code Of The Provider | 321175515 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 207 |
| Number Of Services | 18878 |
| Number Of Medicare Beneficiaries | 3757 |
| Total Submitted Charge Amount | 2125897.85 |
| Total Medicare Allowed Amount | 840610.97 |
| Total Medicare Payment Amount | 675592.12 |
| Total Medicare Standardized Payment Amount | 688792.27 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 12281 |
| Number Of Medicare Beneficiaries With Drug Services | 234 |
| Total Drug Submitted ChargeAmount | 19421.84 |
| Total Drug Medicare AllowedAmount | 4632.62 |
| Total Drug Medicare PaymentAmount | 3588.81 |
| Total Drug Medicare Standardized Payment Amount | 3588.81 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 197 |
| Number Of Medical Services | 6597 |
| Number Of Medicare Beneficiaries With Medical Services | 3756 |
| Total Medical Submitted Charge Amount | 2106476.01 |
| Total Medical Medicare Allowed Amount | 835978.35 |
| Total Medical Medicare Payment Amount | 672003.31 |
| Total Medical Medicare Standardized Payment Amount | 685203.46 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 481 |
| Number Of Beneficiaries Age 65 to 74 | 1694 |
| Number Of Beneficiaries Age 75 to 84 | 1133 |
| Number Of Beneficiaries Age Greater 84 | 449 |
| Number Of Female Beneficiaries | 2634 |
| Number Of Male Beneficiaries | 1123 |
| Number Of Non Hispanic White Beneficiaries | 3197 |
| Number Of Black or African American Beneficiaries | 339 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 138 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 44 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3191 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 566 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.3483 |