| National Provider Identifier [NPI]: | 1093752826 |
| Last Name Of The Provider | KUTHIALA |
| First Name Of The Provider | SEJAL |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5742 BOOTH RD |
| Street Address 2 Of The Provider | SUITE A |
| City Of The Provider | JACKSONVILLE |
| Zip Code Of The Provider | 322075982 |
| 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 | 137 |
| Number Of Services | 202420 |
| Number Of Medicare Beneficiaries | 1554 |
| Total Submitted Charge Amount | 6205808 |
| Total Medicare Allowed Amount | 2381828.23 |
| Total Medicare Payment Amount | 1803685.74 |
| Total Medicare Standardized Payment Amount | 1814171.66 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 62 |
| Number Of Drug Services | 191141 |
| Number Of Medicare Beneficiaries With Drug Services | 397 |
| Total Drug Submitted ChargeAmount | 4795861 |
| Total Drug Medicare AllowedAmount | 1769984.77 |
| Total Drug Medicare PaymentAmount | 1331580.93 |
| Total Drug Medicare Standardized Payment Amount | 1331580.93 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 75 |
| Number Of Medical Services | 11279 |
| Number Of Medicare Beneficiaries With Medical Services | 1553 |
| Total Medical Submitted Charge Amount | 1409947 |
| Total Medical Medicare Allowed Amount | 611843.46 |
| Total Medical Medicare Payment Amount | 472104.81 |
| Total Medical Medicare Standardized Payment Amount | 482590.73 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 203 |
| Number Of Beneficiaries Age 65 to 74 | 666 |
| Number Of Beneficiaries Age 75 to 84 | 473 |
| Number Of Beneficiaries Age Greater 84 | 212 |
| Number Of Female Beneficiaries | 941 |
| Number Of Male Beneficiaries | 613 |
| Number Of Non Hispanic White Beneficiaries | 1232 |
| Number Of Black or African American Beneficiaries | 244 |
| Number Of AsianPacific Islander Beneficiaries | 28 |
| Number Of Hispanic Beneficiaries | 32 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1316 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 238 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 48 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 44 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 2.1172 |