| National Provider Identifier [NPI]: | 1831194919 |
| Last Name Of The Provider | HUDAK |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6301 UNIVERSITY COMMONS |
| Street Address 2 Of The Provider | STE 350 |
| City Of The Provider | SOUTH BEND |
| Zip Code Of The Provider | 466351571 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 96 |
| Number Of Services | 3951.5 |
| Number Of Medicare Beneficiaries | 779 |
| Total Submitted Charge Amount | 1200713.95 |
| Total Medicare Allowed Amount | 311022.8 |
| Total Medicare Payment Amount | 232775.18 |
| Total Medicare Standardized Payment Amount | 245199.73 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 528.5 |
| Number Of Medicare Beneficiaries With Drug Services | 83 |
| Total Drug Submitted ChargeAmount | 242853.8 |
| Total Drug Medicare AllowedAmount | 51339.53 |
| Total Drug Medicare PaymentAmount | 39861.44 |
| Total Drug Medicare Standardized Payment Amount | 39861.44 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 88 |
| Number Of Medical Services | 3423 |
| Number Of Medicare Beneficiaries With Medical Services | 779 |
| Total Medical Submitted Charge Amount | 957860.15 |
| Total Medical Medicare Allowed Amount | 259683.27 |
| Total Medical Medicare Payment Amount | 192913.74 |
| Total Medical Medicare Standardized Payment Amount | 205338.29 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 76 |
| Number Of Beneficiaries Age 65 to 74 | 294 |
| Number Of Beneficiaries Age 75 to 84 | 256 |
| Number Of Beneficiaries Age Greater 84 | 153 |
| Number Of Female Beneficiaries | 143 |
| Number Of Male Beneficiaries | 636 |
| Number Of Non Hispanic White Beneficiaries | 694 |
| Number Of Black or African American Beneficiaries | 55 |
| 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 | 693 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 86 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 25 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.3617 |