| National Provider Identifier [NPI]: | 1922049394 |
| Last Name Of The Provider | CHUDNOVSKY |
| First Name Of The Provider | VADIM |
| 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 | 2601 E CHAPMAN AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | ORANGE |
| Zip Code Of The Provider | 928693206 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 163 |
| Number Of Services | 15027 |
| Number Of Medicare Beneficiaries | 3522 |
| Total Submitted Charge Amount | 282513.04 |
| Total Medicare Allowed Amount | 268400.44 |
| Total Medicare Payment Amount | 203885.99 |
| Total Medicare Standardized Payment Amount | 197894.35 |
| 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 | 163 |
| Number Of Medical Services | 15027 |
| Number Of Medicare Beneficiaries With Medical Services | 3522 |
| Total Medical Submitted Charge Amount | 282513.04 |
| Total Medical Medicare Allowed Amount | 268400.44 |
| Total Medical Medicare Payment Amount | 203885.99 |
| Total Medical Medicare Standardized Payment Amount | 197894.35 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 823 |
| Number Of Beneficiaries Age 65 to 74 | 960 |
| Number Of Beneficiaries Age 75 to 84 | 933 |
| Number Of Beneficiaries Age Greater 84 | 806 |
| Number Of Female Beneficiaries | 1851 |
| Number Of Male Beneficiaries | 1671 |
| Number Of Non Hispanic White Beneficiaries | 1373 |
| Number Of Black or African American Beneficiaries | 447 |
| Number Of AsianPacific Islander Beneficiaries | 606 |
| Number Of Hispanic Beneficiaries | 1026 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 792 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 2730 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 51 |
| Percent Of With Asthma | 18 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 63 |
| Percent Of With Chronic Kidney Disease | 67 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 57 |
| Percent Of With Depression | 45 |
| Percent Of With Diabetes | 66 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 70 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 34 |
| Percent Of With Stroke | 20 |
| Average HCC Risk Score Of Beneficiaries | 3.5452 |