| National Provider Identifier [NPI]: | 1801867676 |
| Last Name Of The Provider | GUNADI |
| First Name Of The Provider | IRWAN |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 612 NOLANA ST |
| Street Address 2 Of The Provider | STE 330 |
| City Of The Provider | MCALLEN |
| Zip Code Of The Provider | 785043026 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 237 |
| Number Of Services | 14335 |
| Number Of Medicare Beneficiaries | 6002 |
| Total Submitted Charge Amount | 848178 |
| Total Medicare Allowed Amount | 410466.22 |
| Total Medicare Payment Amount | 315081.96 |
| Total Medicare Standardized Payment Amount | 328887.18 |
| 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 | 237 |
| Number Of Medical Services | 14335 |
| Number Of Medicare Beneficiaries With Medical Services | 6002 |
| Total Medical Submitted Charge Amount | 848178 |
| Total Medical Medicare Allowed Amount | 410466.22 |
| Total Medical Medicare Payment Amount | 315081.96 |
| Total Medical Medicare Standardized Payment Amount | 328887.18 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 1050 |
| Number Of Beneficiaries Age 65 to 74 | 2104 |
| Number Of Beneficiaries Age 75 to 84 | 1859 |
| Number Of Beneficiaries Age Greater 84 | 989 |
| Number Of Female Beneficiaries | 3954 |
| Number Of Male Beneficiaries | 2048 |
| Number Of Non Hispanic White Beneficiaries | 1605 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 32 |
| Number Of Hispanic Beneficiaries | 4347 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2522 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 3480 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 29 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 38 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 59 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 67 |
| Percent Of With Osteoporosis | 18 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 2.4562 |