| National Provider Identifier [NPI]: | 1003127010 |
| Last Name Of The Provider | HUDDLESTON |
| First Name Of The Provider | ERICA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7910 E WASHINGTON ST |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | INDIANAPOLIS |
| Zip Code Of The Provider | 462196803 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 29 |
| Number Of Services | 329 |
| Number Of Medicare Beneficiaries | 120 |
| Total Submitted Charge Amount | 27731 |
| Total Medicare Allowed Amount | 19912.03 |
| Total Medicare Payment Amount | 14174.4 |
| Total Medicare Standardized Payment Amount | 15009.1 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 51 |
| Number Of Medicare Beneficiaries With Drug Services | 39 |
| Total Drug Submitted ChargeAmount | 2096 |
| Total Drug Medicare AllowedAmount | 1395.97 |
| Total Drug Medicare PaymentAmount | 1346.26 |
| Total Drug Medicare Standardized Payment Amount | 1346.26 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 20 |
| Number Of Medical Services | 278 |
| Number Of Medicare Beneficiaries With Medical Services | 119 |
| Total Medical Submitted Charge Amount | 25635 |
| Total Medical Medicare Allowed Amount | 18516.06 |
| Total Medical Medicare Payment Amount | 12828.14 |
| Total Medical Medicare Standardized Payment Amount | 13662.84 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 34 |
| Number Of Beneficiaries Age 65 to 74 | 48 |
| Number Of Beneficiaries Age 75 to 84 | 24 |
| Number Of Beneficiaries Age Greater 84 | 14 |
| Number Of Female Beneficiaries | 98 |
| Number Of Male Beneficiaries | 22 |
| Number Of Non Hispanic White Beneficiaries | 96 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 82 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 38 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1768 |