| National Provider Identifier [NPI]: | 1346272523 |
| Last Name Of The Provider | GUDE |
| First Name Of The Provider | MODHI |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6001 NW 120TH COURT |
| Street Address 2 Of The Provider | STE 6 |
| City Of The Provider | OKLAHOMA CITY |
| Zip Code Of The Provider | 73162 |
| State Code Of The Provider | OK |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Endocrinology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 62 |
| Number Of Services | 13784 |
| Number Of Medicare Beneficiaries | 447 |
| Total Submitted Charge Amount | 1050492 |
| Total Medicare Allowed Amount | 432255.95 |
| Total Medicare Payment Amount | 358455.39 |
| Total Medicare Standardized Payment Amount | 388930.02 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 77 |
| Number Of Medicare Beneficiaries With Drug Services | 70 |
| Total Drug Submitted ChargeAmount | 6725 |
| Total Drug Medicare AllowedAmount | 3589.11 |
| Total Drug Medicare PaymentAmount | 2736.77 |
| Total Drug Medicare Standardized Payment Amount | 2736.77 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 58 |
| Number Of Medical Services | 13707 |
| Number Of Medicare Beneficiaries With Medical Services | 447 |
| Total Medical Submitted Charge Amount | 1043767 |
| Total Medical Medicare Allowed Amount | 428666.84 |
| Total Medical Medicare Payment Amount | 355718.62 |
| Total Medical Medicare Standardized Payment Amount | 386193.25 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 107 |
| Number Of Beneficiaries Age 65 to 74 | 219 |
| Number Of Beneficiaries Age 75 to 84 | 107 |
| Number Of Beneficiaries Age Greater 84 | 14 |
| Number Of Female Beneficiaries | 304 |
| Number Of Male Beneficiaries | 143 |
| Number Of Non Hispanic White Beneficiaries | 341 |
| Number Of Black or African American Beneficiaries | 53 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 13 |
| Number Of American Indian Alaska Native Beneficiaries | 19 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 350 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 97 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 49 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 64 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.5087 |