| National Provider Identifier [NPI]: | 1649410036 |
| Last Name Of The Provider | KUMTHEKAR |
| First Name Of The Provider | PRIYA |
| Middle Initial Of The Provider | U |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1 W SUPERIOR ST APT 801 |
| Street Address 2 Of The Provider | |
| City Of The Provider | CHICAGO |
| Zip Code Of The Provider | 606548810 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 96 |
| Number Of Services | 29377 |
| Number Of Medicare Beneficiaries | 226 |
| Total Submitted Charge Amount | 2829132 |
| Total Medicare Allowed Amount | 719304.1 |
| Total Medicare Payment Amount | 553370.7 |
| Total Medicare Standardized Payment Amount | 550000.26 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 55 |
| Number Of Drug Services | 28365 |
| Number Of Medicare Beneficiaries With Drug Services | 130 |
| Total Drug Submitted ChargeAmount | 2426647 |
| Total Drug Medicare AllowedAmount | 635512.98 |
| Total Drug Medicare PaymentAmount | 489216.09 |
| Total Drug Medicare Standardized Payment Amount | 489216.09 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 41 |
| Number Of Medical Services | 1012 |
| Number Of Medicare Beneficiaries With Medical Services | 225 |
| Total Medical Submitted Charge Amount | 402485 |
| Total Medical Medicare Allowed Amount | 83791.12 |
| Total Medical Medicare Payment Amount | 64154.61 |
| Total Medical Medicare Standardized Payment Amount | 60784.17 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 56 |
| Number Of Beneficiaries Age 65 to 74 | 108 |
| Number Of Beneficiaries Age 75 to 84 | 51 |
| Number Of Beneficiaries Age Greater 84 | 11 |
| Number Of Female Beneficiaries | 121 |
| Number Of Male Beneficiaries | 105 |
| Number Of Non Hispanic White Beneficiaries | 154 |
| Number Of Black or African American Beneficiaries | 37 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 19 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 171 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 55 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 36 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 43 |
| Percent Of With Hypertension | 61 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 2.0011 |