| National Provider Identifier [NPI]: | 1235392135 |
| Last Name Of The Provider | CHAUDHURI |
| First Name Of The Provider | DEBANIK |
| 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 | 419 E DONALD ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | WATERLOO |
| Zip Code Of The Provider | 507031500 |
| State Code Of The Provider | IA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 91 |
| Number Of Services | 6414 |
| Number Of Medicare Beneficiaries | 1716 |
| Total Submitted Charge Amount | 1816921 |
| Total Medicare Allowed Amount | 697942.97 |
| Total Medicare Payment Amount | 533587.56 |
| Total Medicare Standardized Payment Amount | 573487.13 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 843 |
| Number Of Medicare Beneficiaries With Drug Services | 204 |
| Total Drug Submitted ChargeAmount | 81593 |
| Total Drug Medicare AllowedAmount | 43172.38 |
| Total Drug Medicare PaymentAmount | 33724.36 |
| Total Drug Medicare Standardized Payment Amount | 33724.36 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 88 |
| Number Of Medical Services | 5571 |
| Number Of Medicare Beneficiaries With Medical Services | 1716 |
| Total Medical Submitted Charge Amount | 1735328 |
| Total Medical Medicare Allowed Amount | 654770.59 |
| Total Medical Medicare Payment Amount | 499863.2 |
| Total Medical Medicare Standardized Payment Amount | 539762.77 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 129 |
| Number Of Beneficiaries Age 65 to 74 | 694 |
| Number Of Beneficiaries Age 75 to 84 | 593 |
| Number Of Beneficiaries Age Greater 84 | 300 |
| Number Of Female Beneficiaries | 833 |
| Number Of Male Beneficiaries | 883 |
| Number Of Non Hispanic White Beneficiaries | 1614 |
| Number Of Black or African American Beneficiaries | 82 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1481 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 235 |
| Percent Of With Atrial Fibrillation | 29 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 38 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 68 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.5293 |