| National Provider Identifier [NPI]: | 1730132051 |
| Last Name Of The Provider | KUEHN |
| First Name Of The Provider | DOUGLAS |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 121 S SAINT LOUIS BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | SOUTH BEND |
| Zip Code Of The Provider | 466172924 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 166 |
| Number Of Services | 6304 |
| Number Of Medicare Beneficiaries | 3125 |
| Total Submitted Charge Amount | 586181.96 |
| Total Medicare Allowed Amount | 192009.12 |
| Total Medicare Payment Amount | 142916.51 |
| Total Medicare Standardized Payment Amount | 151789.34 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 1421 |
| Number Of Medicare Beneficiaries With Drug Services | 100 |
| Total Drug Submitted ChargeAmount | 3551.13 |
| Total Drug Medicare AllowedAmount | 3208.57 |
| Total Drug Medicare PaymentAmount | 2506.39 |
| Total Drug Medicare Standardized Payment Amount | 2506.39 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 161 |
| Number Of Medical Services | 4883 |
| Number Of Medicare Beneficiaries With Medical Services | 3125 |
| Total Medical Submitted Charge Amount | 582630.83 |
| Total Medical Medicare Allowed Amount | 188800.55 |
| Total Medical Medicare Payment Amount | 140410.12 |
| Total Medical Medicare Standardized Payment Amount | 149282.95 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 597 |
| Number Of Beneficiaries Age 65 to 74 | 996 |
| Number Of Beneficiaries Age 75 to 84 | 884 |
| Number Of Beneficiaries Age Greater 84 | 648 |
| Number Of Female Beneficiaries | 1816 |
| Number Of Male Beneficiaries | 1309 |
| Number Of Non Hispanic White Beneficiaries | 2822 |
| Number Of Black or African American Beneficiaries | 203 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 57 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 32 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2321 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 804 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 34 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.7411 |