| National Provider Identifier [NPI]: | 1083744486 |
| Last Name Of The Provider | BADRUDDUJA |
| First Name Of The Provider | MUSTAFA |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6308 8TH AVE |
| Street Address 2 Of The Provider | SUITE 3050 |
| City Of The Provider | KENOSHA |
| Zip Code Of The Provider | 531435031 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | General Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 137 |
| Number Of Services | 1215 |
| Number Of Medicare Beneficiaries | 284 |
| Total Submitted Charge Amount | 729134 |
| Total Medicare Allowed Amount | 217388.9 |
| Total Medicare Payment Amount | 167163.6 |
| Total Medicare Standardized Payment Amount | 175936.39 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 137 |
| Number Of Medical Services | 1215 |
| Number Of Medicare Beneficiaries With Medical Services | 284 |
| Total Medical Submitted Charge Amount | 729134 |
| Total Medical Medicare Allowed Amount | 217388.9 |
| Total Medical Medicare Payment Amount | 167163.6 |
| Total Medical Medicare Standardized Payment Amount | 175936.39 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 82 |
| Number Of Beneficiaries Age 65 to 74 | 80 |
| Number Of Beneficiaries Age 75 to 84 | 67 |
| Number Of Beneficiaries Age Greater 84 | 55 |
| Number Of Female Beneficiaries | 166 |
| Number Of Male Beneficiaries | 118 |
| Number Of Non Hispanic White Beneficiaries | 237 |
| Number Of Black or African American Beneficiaries | 27 |
| 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 | 181 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 103 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.6508 |