| National Provider Identifier [NPI]: | 1831193481 |
| Last Name Of The Provider | CUSHMAN |
| First Name Of The Provider | WALTER |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4005 24TH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | LUBBOCK |
| Zip Code Of The Provider | 794101835 |
| 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 | 270 |
| Number Of Services | 5465 |
| Number Of Medicare Beneficiaries | 2113 |
| Total Submitted Charge Amount | 1049357 |
| Total Medicare Allowed Amount | 176252.86 |
| Total Medicare Payment Amount | 135927.3 |
| Total Medicare Standardized Payment Amount | 144929.79 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 1765 |
| Number Of Medicare Beneficiaries With Drug Services | 28 |
| Total Drug Submitted ChargeAmount | 2088 |
| Total Drug Medicare AllowedAmount | 599 |
| Total Drug Medicare PaymentAmount | 469.63 |
| Total Drug Medicare Standardized Payment Amount | 469.63 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 264 |
| Number Of Medical Services | 3700 |
| Number Of Medicare Beneficiaries With Medical Services | 2113 |
| Total Medical Submitted Charge Amount | 1047269 |
| Total Medical Medicare Allowed Amount | 175653.86 |
| Total Medical Medicare Payment Amount | 135457.67 |
| Total Medical Medicare Standardized Payment Amount | 144460.16 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 305 |
| Number Of Beneficiaries Age 65 to 74 | 785 |
| Number Of Beneficiaries Age 75 to 84 | 699 |
| Number Of Beneficiaries Age Greater 84 | 324 |
| Number Of Female Beneficiaries | 1304 |
| Number Of Male Beneficiaries | 809 |
| Number Of Non Hispanic White Beneficiaries | 1559 |
| Number Of Black or African American Beneficiaries | 92 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 438 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1605 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 508 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 40 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 58 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 58 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.8027 |