| National Provider Identifier [NPI]: | 1457334914 |
| Last Name Of The Provider | TETREAULT |
| First Name Of The Provider | SCOTT |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2626 CARE DR |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | TALLAHASSEE |
| Zip Code Of The Provider | 323084495 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 151 |
| Number Of Services | 160078 |
| Number Of Medicare Beneficiaries | 190 |
| Total Submitted Charge Amount | 5865631 |
| Total Medicare Allowed Amount | 2194634.46 |
| Total Medicare Payment Amount | 1719765.69 |
| Total Medicare Standardized Payment Amount | 1712523.43 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 69 |
| Number Of Drug Services | 151290 |
| Number Of Medicare Beneficiaries With Drug Services | 107 |
| Total Drug Submitted ChargeAmount | 4860216 |
| Total Drug Medicare AllowedAmount | 1837348.22 |
| Total Drug Medicare PaymentAmount | 1433822.15 |
| Total Drug Medicare Standardized Payment Amount | 1433822.15 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 82 |
| Number Of Medical Services | 8788 |
| Number Of Medicare Beneficiaries With Medical Services | 189 |
| Total Medical Submitted Charge Amount | 1005415 |
| Total Medical Medicare Allowed Amount | 357286.24 |
| Total Medical Medicare Payment Amount | 285943.54 |
| Total Medical Medicare Standardized Payment Amount | 278701.28 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 25 |
| Number Of Beneficiaries Age 65 to 74 | 82 |
| Number Of Beneficiaries Age 75 to 84 | 66 |
| Number Of Beneficiaries Age Greater 84 | 17 |
| Number Of Female Beneficiaries | 100 |
| Number Of Male Beneficiaries | 90 |
| Number Of Non Hispanic White Beneficiaries | 149 |
| Number Of Black or African American Beneficiaries | |
| 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 | 154 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 36 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 46 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 49 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.8873 |