| National Provider Identifier [NPI]: | 1538154075 |
| Last Name Of The Provider | KHLUDENEV |
| First Name Of The Provider | KONSTANTIN |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 15825 SHADY GROVE RD |
| Street Address 2 Of The Provider | SUITE 140 |
| City Of The Provider | ROCKVILLE |
| Zip Code Of The Provider | 208504008 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 63 |
| Number Of Services | 2390 |
| Number Of Medicare Beneficiaries | 511 |
| Total Submitted Charge Amount | 568519.87 |
| Total Medicare Allowed Amount | 226974.98 |
| Total Medicare Payment Amount | 169420.55 |
| Total Medicare Standardized Payment Amount | 154639.61 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 138 |
| Number Of Medicare Beneficiaries With Drug Services | 107 |
| Total Drug Submitted ChargeAmount | 19489.34 |
| Total Drug Medicare AllowedAmount | 8799.82 |
| Total Drug Medicare PaymentAmount | 8615.45 |
| Total Drug Medicare Standardized Payment Amount | 8615.45 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 53 |
| Number Of Medical Services | 2252 |
| Number Of Medicare Beneficiaries With Medical Services | 511 |
| Total Medical Submitted Charge Amount | 549030.53 |
| Total Medical Medicare Allowed Amount | 218175.16 |
| Total Medical Medicare Payment Amount | 160805.1 |
| Total Medical Medicare Standardized Payment Amount | 146024.16 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 35 |
| Number Of Beneficiaries Age 65 to 74 | 194 |
| Number Of Beneficiaries Age 75 to 84 | 184 |
| Number Of Beneficiaries Age Greater 84 | 98 |
| Number Of Female Beneficiaries | 262 |
| Number Of Male Beneficiaries | 249 |
| Number Of Non Hispanic White Beneficiaries | 413 |
| Number Of Black or African American Beneficiaries | 26 |
| Number Of AsianPacific Islander Beneficiaries | 18 |
| Number Of Hispanic Beneficiaries | 30 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 24 |
| Number Of Beneficiaries With Medicare Only Entitlement | 316 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 195 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.3307 |