| National Provider Identifier [NPI]: | 1669482188 |
| Last Name Of The Provider | KUDIA |
| First Name Of The Provider | ASHFAQ |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1301 PLANTATION ISLAND DR |
| Street Address 2 Of The Provider | SUITE 302A |
| City Of The Provider | ST AUGUSTINE |
| Zip Code Of The Provider | 320803717 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 42 |
| Number Of Services | 6898 |
| Number Of Medicare Beneficiaries | 1043 |
| Total Submitted Charge Amount | 849420 |
| Total Medicare Allowed Amount | 641326.76 |
| Total Medicare Payment Amount | 493574.24 |
| Total Medicare Standardized Payment Amount | 493023.74 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 143 |
| Number Of Medicare Beneficiaries With Drug Services | 125 |
| Total Drug Submitted ChargeAmount | 6425 |
| Total Drug Medicare AllowedAmount | 3931.56 |
| Total Drug Medicare PaymentAmount | 3852.63 |
| Total Drug Medicare Standardized Payment Amount | 3852.63 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 39 |
| Number Of Medical Services | 6755 |
| Number Of Medicare Beneficiaries With Medical Services | 1043 |
| Total Medical Submitted Charge Amount | 842995 |
| Total Medical Medicare Allowed Amount | 637395.2 |
| Total Medical Medicare Payment Amount | 489721.61 |
| Total Medical Medicare Standardized Payment Amount | 489171.11 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 120 |
| Number Of Beneficiaries Age 65 to 74 | 437 |
| Number Of Beneficiaries Age 75 to 84 | 303 |
| Number Of Beneficiaries Age Greater 84 | 183 |
| Number Of Female Beneficiaries | 572 |
| Number Of Male Beneficiaries | 471 |
| Number Of Non Hispanic White Beneficiaries | 934 |
| Number Of Black or African American Beneficiaries | 75 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 15 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 866 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 177 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 54 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.4678 |