| National Provider Identifier [NPI]: | 1033225248 |
| Last Name Of The Provider | KUKU |
| First Name Of The Provider | ADEKUNLE |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | US HWY 491 NORTH |
| Street Address 2 Of The Provider | |
| City Of The Provider | SHIPROCK |
| Zip Code Of The Provider | 87420 |
| State Code Of The Provider | NM |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 24 |
| Number Of Services | 860 |
| Number Of Medicare Beneficiaries | 423 |
| Total Submitted Charge Amount | 185332 |
| Total Medicare Allowed Amount | 113962.12 |
| Total Medicare Payment Amount | 88678.94 |
| Total Medicare Standardized Payment Amount | 91749.78 |
| 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 | 24 |
| Number Of Medical Services | 860 |
| Number Of Medicare Beneficiaries With Medical Services | 423 |
| Total Medical Submitted Charge Amount | 185332 |
| Total Medical Medicare Allowed Amount | 113962.12 |
| Total Medical Medicare Payment Amount | 88678.94 |
| Total Medical Medicare Standardized Payment Amount | 91749.78 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 99 |
| Number Of Beneficiaries Age 65 to 74 | 129 |
| Number Of Beneficiaries Age 75 to 84 | 121 |
| Number Of Beneficiaries Age Greater 84 | 74 |
| Number Of Female Beneficiaries | 220 |
| Number Of Male Beneficiaries | 203 |
| Number Of Non Hispanic White Beneficiaries | 396 |
| 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 | 244 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 179 |
| Percent Of With Atrial Fibrillation | 25 |
| Percent Of With Alzheimers Disease or Dementia | 22 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 49 |
| Percent Of With Chronic Kidney Disease | 60 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 49 |
| Percent Of With Depression | 37 |
| Percent Of With Diabetes | 48 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 60 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 14 |
| Percent Of With Stroke | 19 |
| Average HCC Risk Score Of Beneficiaries | 2.6949 |