| National Provider Identifier [NPI]: | 1265742704 |
| Last Name Of The Provider | CHODUN |
| First Name Of The Provider | CAROL |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | ACNP-BC |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 24211 LITTLE MACK AVENUE |
| Street Address 2 Of The Provider | EASTLAKE CARDIOVASCULAR |
| City Of The Provider | ST CLAIR SHORES |
| Zip Code Of The Provider | 48080 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 5 |
| Number Of Services | 766 |
| Number Of Medicare Beneficiaries | 283 |
| Total Submitted Charge Amount | 93515 |
| Total Medicare Allowed Amount | 67645.84 |
| Total Medicare Payment Amount | 53034.44 |
| Total Medicare Standardized Payment Amount | 60758.36 |
| 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 | 5 |
| Number Of Medical Services | 766 |
| Number Of Medicare Beneficiaries With Medical Services | 283 |
| Total Medical Submitted Charge Amount | 93515 |
| Total Medical Medicare Allowed Amount | 67645.84 |
| Total Medical Medicare Payment Amount | 53034.44 |
| Total Medical Medicare Standardized Payment Amount | 60758.36 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 30 |
| Number Of Beneficiaries Age 65 to 74 | 72 |
| Number Of Beneficiaries Age 75 to 84 | 93 |
| Number Of Beneficiaries Age Greater 84 | 88 |
| Number Of Female Beneficiaries | 163 |
| Number Of Male Beneficiaries | 120 |
| Number Of Non Hispanic White Beneficiaries | 199 |
| Number Of Black or African American Beneficiaries | 66 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 205 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 78 |
| Percent Of With Atrial Fibrillation | 32 |
| Percent Of With Alzheimers Disease or Dementia | 53 |
| Percent Of With Asthma | 17 |
| Percent Of With Cancer | 20 |
| Percent Of With Heart Failure | 65 |
| Percent Of With Chronic Kidney Disease | 66 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 41 |
| Percent Of With Depression | 54 |
| Percent Of With Diabetes | 53 |
| Percent Of With Hyperlipidemia | 73 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 74 |
| Percent Of With Osteoporosis | 18 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 63 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 23 |
| Percent Of With Stroke | 24 |
| Average HCC Risk Score Of Beneficiaries | 2.6622 |