| National Provider Identifier [NPI]: | 1538105911 |
| Last Name Of The Provider | KHUDEIRA |
| First Name Of The Provider | ABDULKAREEM |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4651 W. 79TH ST |
| Street Address 2 Of The Provider | SUITE 204 |
| City Of The Provider | CHICAGO |
| Zip Code Of The Provider | 606521775 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 26 |
| Number Of Services | 733 |
| Number Of Medicare Beneficiaries | 99 |
| Total Submitted Charge Amount | 77676.6 |
| Total Medicare Allowed Amount | 60577.36 |
| Total Medicare Payment Amount | 42568.12 |
| Total Medicare Standardized Payment Amount | 40070.49 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 31 |
| Number Of Medicare Beneficiaries With Drug Services | 31 |
| Total Drug Submitted ChargeAmount | 950 |
| Total Drug Medicare AllowedAmount | 402.31 |
| Total Drug Medicare PaymentAmount | 386.23 |
| Total Drug Medicare Standardized Payment Amount | 386.23 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 24 |
| Number Of Medical Services | 702 |
| Number Of Medicare Beneficiaries With Medical Services | 99 |
| Total Medical Submitted Charge Amount | 76726.6 |
| Total Medical Medicare Allowed Amount | 60175.05 |
| Total Medical Medicare Payment Amount | 42181.89 |
| Total Medical Medicare Standardized Payment Amount | 39684.26 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 47 |
| Number Of Beneficiaries Age 75 to 84 | 28 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 47 |
| Number Of Male Beneficiaries | 52 |
| Number Of Non Hispanic White Beneficiaries | 64 |
| Number Of Black or African American Beneficiaries | |
| 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 | 15 |
| Number Of Beneficiaries With Medicare Only Entitlement | 17 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 82 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 11 |
| Percent Of With Diabetes | 75 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 72 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 0 |
| Average HCC Risk Score Of Beneficiaries | 1.0675 |