| National Provider Identifier [NPI]: | 1053300228 |
| Last Name Of The Provider | CHUDOW |
| First Name Of The Provider | CLARA |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 18 SQUADRON BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | NEW CITY |
| Zip Code Of The Provider | 109565210 |
| State Code Of The Provider | NY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 125 |
| Number Of Services | 6122 |
| Number Of Medicare Beneficiaries | 3540 |
| Total Submitted Charge Amount | 957453 |
| Total Medicare Allowed Amount | 125031.31 |
| Total Medicare Payment Amount | 93080.99 |
| Total Medicare Standardized Payment Amount | 96502.62 |
| Drug Suppress Indicator | * |
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| Medical SuppressIndicator | # |
| Number Of HCPCS Associated With MedicalServices | |
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| Number Of Medicare Beneficiaries With Medical Services | |
| Total Medical Submitted Charge Amount | |
| Total Medical Medicare Allowed Amount | |
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| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 827 |
| Number Of Beneficiaries Age 65 to 74 | 1239 |
| Number Of Beneficiaries Age 75 to 84 | 905 |
| Number Of Beneficiaries Age Greater 84 | 569 |
| Number Of Female Beneficiaries | 2126 |
| Number Of Male Beneficiaries | 1414 |
| Number Of Non Hispanic White Beneficiaries | 3413 |
| Number Of Black or African American Beneficiaries | 43 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 40 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 27 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2296 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1244 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 33 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 17 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.7104 |