| National Provider Identifier [NPI]: | 1538121421 |
| Last Name Of The Provider | ZEWDIE |
| First Name Of The Provider | WUDENEH |
| 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 | 9230 E RENO AVE |
| Street Address 2 Of The Provider | SUITE - B |
| City Of The Provider | MIDWEST CITY |
| Zip Code Of The Provider | 731303320 |
| State Code Of The Provider | OK |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nephrology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 28 |
| Number Of Services | 4940 |
| Number Of Medicare Beneficiaries | 1105 |
| Total Submitted Charge Amount | 844129.06 |
| Total Medicare Allowed Amount | 509358.4 |
| Total Medicare Payment Amount | 379222.16 |
| Total Medicare Standardized Payment Amount | 405736.98 |
| 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 | 28 |
| Number Of Medical Services | 4940 |
| Number Of Medicare Beneficiaries With Medical Services | 1105 |
| Total Medical Submitted Charge Amount | 844129.06 |
| Total Medical Medicare Allowed Amount | 509358.4 |
| Total Medical Medicare Payment Amount | 379222.16 |
| Total Medical Medicare Standardized Payment Amount | 405736.98 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 202 |
| Number Of Beneficiaries Age 65 to 74 | 366 |
| Number Of Beneficiaries Age 75 to 84 | 359 |
| Number Of Beneficiaries Age Greater 84 | 178 |
| Number Of Female Beneficiaries | 593 |
| Number Of Male Beneficiaries | 512 |
| Number Of Non Hispanic White Beneficiaries | 840 |
| Number Of Black or African American Beneficiaries | 144 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 27 |
| Number Of American Indian Alaska Native Beneficiaries | 79 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 819 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 286 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 52 |
| Percent Of With Chronic Kidney Disease | 75 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 62 |
| Percent Of With Hyperlipidemia | 74 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 3.0887 |