| National Provider Identifier [NPI]: | 1932153640 |
| Last Name Of The Provider | PUK |
| 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 | 909 E SAN MARNAN DRIVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | WATERLOO |
| Zip Code Of The Provider | 507025611 |
| State Code Of The Provider | IA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 96 |
| Number Of Services | 8441 |
| Number Of Medicare Beneficiaries | 1817 |
| Total Submitted Charge Amount | 2737802.8 |
| Total Medicare Allowed Amount | 1205329.4 |
| Total Medicare Payment Amount | 902869.21 |
| Total Medicare Standardized Payment Amount | 957306.27 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 1725 |
| Number Of Medicare Beneficiaries With Drug Services | 55 |
| Total Drug Submitted ChargeAmount | 448225.8 |
| Total Drug Medicare AllowedAmount | 283660.55 |
| Total Drug Medicare PaymentAmount | 222232.62 |
| Total Drug Medicare Standardized Payment Amount | 222232.62 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 90 |
| Number Of Medical Services | 6716 |
| Number Of Medicare Beneficiaries With Medical Services | 1817 |
| Total Medical Submitted Charge Amount | 2289577 |
| Total Medical Medicare Allowed Amount | 921668.85 |
| Total Medical Medicare Payment Amount | 680636.59 |
| Total Medical Medicare Standardized Payment Amount | 735073.65 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 54 |
| Number Of Beneficiaries Age 65 to 74 | 707 |
| Number Of Beneficiaries Age 75 to 84 | 722 |
| Number Of Beneficiaries Age Greater 84 | 334 |
| Number Of Female Beneficiaries | 1174 |
| Number Of Male Beneficiaries | 643 |
| Number Of Non Hispanic White Beneficiaries | 1741 |
| Number Of Black or African American Beneficiaries | 44 |
| 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 | 15 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1713 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 104 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 2 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.0285 |