| National Provider Identifier [NPI]: | 1144310004 |
| Last Name Of The Provider | KUDENCHUK |
| First Name Of The Provider | PETER |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | UNIVERSITY OF WASHINGTON MEDICAL CTR |
| Street Address 2 Of The Provider | 1959 NE PACIFIC ST |
| City Of The Provider | SEATTLE |
| Zip Code Of The Provider | 981956043 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiac Electrophysiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 28 |
| Number Of Services | 1241 |
| Number Of Medicare Beneficiaries | 744 |
| Total Submitted Charge Amount | 70035.8 |
| Total Medicare Allowed Amount | 27341.56 |
| Total Medicare Payment Amount | 19431.6 |
| Total Medicare Standardized Payment Amount | 19685.09 |
| 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 | 28 |
| Number Of Medical Services | 1241 |
| Number Of Medicare Beneficiaries With Medical Services | 744 |
| Total Medical Submitted Charge Amount | 70035.8 |
| Total Medical Medicare Allowed Amount | 27341.56 |
| Total Medical Medicare Payment Amount | 19431.6 |
| Total Medical Medicare Standardized Payment Amount | 19685.09 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 167 |
| Number Of Beneficiaries Age 65 to 74 | 295 |
| Number Of Beneficiaries Age 75 to 84 | 185 |
| Number Of Beneficiaries Age Greater 84 | 97 |
| Number Of Female Beneficiaries | 323 |
| Number Of Male Beneficiaries | 421 |
| Number Of Non Hispanic White Beneficiaries | 608 |
| Number Of Black or African American Beneficiaries | 55 |
| Number Of AsianPacific Islander Beneficiaries | 38 |
| Number Of Hispanic Beneficiaries | 22 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 534 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 210 |
| Percent Of With Atrial Fibrillation | 30 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 39 |
| Percent Of With Chronic Kidney Disease | 46 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 2.1363 |