| National Provider Identifier [NPI]: | 1982633319 |
| Last Name Of The Provider | KLOUDA |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 700 OLYMPIC PLAZA CIR |
| Street Address 2 Of The Provider | STE. 101 |
| City Of The Provider | TYLER |
| Zip Code Of The Provider | 757011951 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 23 |
| Number Of Services | 6340 |
| Number Of Medicare Beneficiaries | 5108 |
| Total Submitted Charge Amount | 764717 |
| Total Medicare Allowed Amount | 227371.58 |
| Total Medicare Payment Amount | 205003.12 |
| Total Medicare Standardized Payment Amount | 212238.29 |
| 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 | 23 |
| Number Of Medical Services | 6340 |
| Number Of Medicare Beneficiaries With Medical Services | 5108 |
| Total Medical Submitted Charge Amount | 764717 |
| Total Medical Medicare Allowed Amount | 227371.58 |
| Total Medical Medicare Payment Amount | 205003.12 |
| Total Medical Medicare Standardized Payment Amount | 212238.29 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 634 |
| Number Of Beneficiaries Age 65 to 74 | 2643 |
| Number Of Beneficiaries Age 75 to 84 | 1530 |
| Number Of Beneficiaries Age Greater 84 | 301 |
| Number Of Female Beneficiaries | 5064 |
| Number Of Male Beneficiaries | 44 |
| Number Of Non Hispanic White Beneficiaries | 4329 |
| Number Of Black or African American Beneficiaries | 610 |
| Number Of AsianPacific Islander Beneficiaries | 18 |
| Number Of Hispanic Beneficiaries | 123 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 4310 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 798 |
| Percent Of With Atrial Fibrillation | 5 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.9307 |