| National Provider Identifier [NPI]: | 1629011747 |
| Last Name Of The Provider | KUDAIMI |
| First Name Of The Provider | MUHAMMAD |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 801 MACARTHUR BLVD |
| Street Address 2 Of The Provider | SUITE 303 |
| City Of The Provider | MUNSTER |
| Zip Code Of The Provider | 463212915 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Gastroenterology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 47 |
| Number Of Services | 4757 |
| Number Of Medicare Beneficiaries | 1097 |
| Total Submitted Charge Amount | 1413059 |
| Total Medicare Allowed Amount | 546662.64 |
| Total Medicare Payment Amount | 426519.99 |
| Total Medicare Standardized Payment Amount | 434931.22 |
| 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 | 47 |
| Number Of Medical Services | 4757 |
| Number Of Medicare Beneficiaries With Medical Services | 1097 |
| Total Medical Submitted Charge Amount | 1413059 |
| Total Medical Medicare Allowed Amount | 546662.64 |
| Total Medical Medicare Payment Amount | 426519.99 |
| Total Medical Medicare Standardized Payment Amount | 434931.22 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 206 |
| Number Of Beneficiaries Age 65 to 74 | 417 |
| Number Of Beneficiaries Age 75 to 84 | 306 |
| Number Of Beneficiaries Age Greater 84 | 168 |
| Number Of Female Beneficiaries | 616 |
| Number Of Male Beneficiaries | 481 |
| Number Of Non Hispanic White Beneficiaries | 505 |
| Number Of Black or African American Beneficiaries | 287 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 293 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 776 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 321 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 42 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 32 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 51 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 59 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 2.2099 |