| National Provider Identifier [NPI]: | 1114964160 |
| Last Name Of The Provider | WOUDEN |
| First Name Of The Provider | JACOB |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2000 MOWRY AVE |
| Street Address 2 Of The Provider | WASHINGTON RADIOLOGISTS MEDICAL GROUP |
| City Of The Provider | FREMONT |
| Zip Code Of The Provider | 945381716 |
| 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 | 213 |
| Number Of Services | 5632 |
| Number Of Medicare Beneficiaries | 3030 |
| Total Submitted Charge Amount | 1244935.2 |
| Total Medicare Allowed Amount | 194743.49 |
| Total Medicare Payment Amount | 153679.19 |
| Total Medicare Standardized Payment Amount | 142997.46 |
| 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 | 213 |
| Number Of Medical Services | 5632 |
| Number Of Medicare Beneficiaries With Medical Services | 3030 |
| Total Medical Submitted Charge Amount | 1244935.2 |
| Total Medical Medicare Allowed Amount | 194743.49 |
| Total Medical Medicare Payment Amount | 153679.19 |
| Total Medical Medicare Standardized Payment Amount | 142997.46 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 368 |
| Number Of Beneficiaries Age 65 to 74 | 1013 |
| Number Of Beneficiaries Age 75 to 84 | 1012 |
| Number Of Beneficiaries Age Greater 84 | 637 |
| Number Of Female Beneficiaries | 1923 |
| Number Of Male Beneficiaries | 1107 |
| Number Of Non Hispanic White Beneficiaries | 1399 |
| Number Of Black or African American Beneficiaries | 152 |
| Number Of AsianPacific Islander Beneficiaries | 876 |
| Number Of Hispanic Beneficiaries | 468 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1711 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1319 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 22 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 34 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 48 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 52 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.8218 |